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Angioscopy in 2015: the Role of Macroscopic Pathology in Living Patients

  • Intravascular Imaging (I.-K. Jang, Section Editor)
  • Published:
Current Cardiovascular Imaging Reports Aims and scope Submit manuscript

Abstract

Angioscopy can detect lipid-rich yellow plaques that are regarded as vulnerable plaques. The patients who have multiple yellow plaques are regarded as vulnerable patients. The disrupted plaques can also be visualized directly by angioscopy, but they can be detected more sensitively as the presence of thrombus. On the other hand, angioscopy can also evaluate the neointima formed over stents. The follow-up angioscopic examinations after the implantation of coronary stents visualized atherosclerosis progression as the formation of yellow plaque in the stent-implanted segments. Recently, the presence of yellow plaque at 1 year after stent implantation has been demonstrated to be the risk of future stent failure. Atherosclerosis progression shown by the formation of yellow plaque may be the major mechanism and “final common pathway” for the very-late stent failure.

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References

Papers of particular interest, published recently, have been highlighted as: •• Of major importance

  1. Ueda Y, Ohtani T, Shimizu M, Hirayama A, Kodama K. Assessment of plaque vulnerability by angioscopic classification of plaque color. Am Heart J. 2004;148:333–5.

    Article  PubMed  Google Scholar 

  2. Kubo T, Imanishi T, Takarada S, Kuroi A, Ueno S, Yamano T, et al. Implication of plaque color classification for assessing plaque vulnerability: a coronary angioscopy and optical coherence tomography investigation. J Am Coll Cardiol Intv. 2008;1:74–80.

    Article  Google Scholar 

  3. Ohtani T, Ueda Y, Mizote I, Oyabu J, Okada K, Hirayama A, et al. Number of yellow plaques detected in a coronary artery is associated with future risk of acute coronary syndrome: detection of vulnerable patients by angioscopy. J Am Coll Cardiol. 2006;47:2194–200. The number of yellow plaques detected by angioscopy was associated with the risk of future coronary event.

    Article  PubMed  Google Scholar 

  4. Nakanishi N, Nakamura T, Yamano T, Shiraishi H, Matoba S, Matsumuro A, et al. Angioscopic observation in chronic thromboembolic pulmonary hypertension before and after balloon pulmonary angioplasty. J Cardiovasc Med (Hagerstown). 2014.

  5. Aono J, Ikeda S, Katsumata Y, Higashi H, Ohshima K, Ishibashi K, et al. Correlation between plaque vulnerability of aorta and coronary artery: an evaluation of plaque activity by direct visualization with angioscopy. Int J Cardiovasc Imaging. 2015;31:1107–14.

    Article  PubMed Central  PubMed  Google Scholar 

  6. Komatsu S, Ohara T, Takahashi S, Takewa M, Minamiguchi H, Imai A, et al. Early detection of vulnerable atherosclerotic plaque for risk reduction of acute aortic rupture and thromboemboli and atheroemboli using non-obstructive angioscopy. Circ J. 2015;79:742–50. Angiosocpic observation of aorta revealed terrible atherosclerotic condition with multiple plaque ruptures that cannot be identified by CT imaging.

    Article  PubMed  Google Scholar 

  7. Oyabu J, Ueda Y, Ogasawara N, Okada K, Hirayama A, Kodama K. Angioscopic evaluation of neointima coverage: sirolimus drug-eluting stent vs. bare metal stent. Am Heart J. 2006;152:1168–74.

    Article  CAS  PubMed  Google Scholar 

  8. Higo T, Ueda Y, Oyabu J, Okada K, Nishio M, Hirata A, et al. Atherosclerotic and thrombogenic neointima formed over sirolimus drug-eluting stent. An angioscopic study. J Am Coll Cardiol Img. 2009;2:616–24. First demonstration of neoatherosclerosis after DES implantation in the patients alive.

    Article  Google Scholar 

  9. Mitsutake Y, Ueno T, Yokoyama S, Sasaki K, Sugi Y, Toyama Y, et al. Coronary endothelial dysfunction distal to stent of first-generation drug-eluting stents. J Am Coll Cardiol Intv. 2012;5:966–73.

    Article  Google Scholar 

  10. Mitsutake Y, Ueno T, Ikeno F, Yokoyama S, Sasaki KI, Nakayoshi T, et al. Serial changes of coronary endothelial function and arterial healing after paclitaxel-eluting stent implantation. Cardiovasc Interv Ther. 2015.

  11. Ishihara T, Awata M, Fujita M, Watanabe T, Iida O, Ishida Y, et al. Angioscopic assessment of peri-stent contrast staining following drug-eluting stent implantation. Circ J. 2014;78:122–7.

    Article  PubMed  Google Scholar 

  12. Dai K, Ishihara M, Inoue I, Kawagoe T, Shimatani Y, Miura F, et al. Coronary angioscopic findings 9 months after everolimus-eluting stent implantation compared with sirolimus-eluting stents. J Cardiol. 2013;61:22–30.

    Article  PubMed  Google Scholar 

  13. Sawada T, Shinke T, Otake H, Mizoguchi T, Iwasaki M, Emoto T, et al. Comparisons of detailed arterial healing response at seven months following implantation of an everolimus- or sirolimus-eluting stent in patients with ST-segment elevation myocardial infarction. Int J Cardiol. 2013;168:960–6.

    Article  PubMed  Google Scholar 

  14. Ishihara T, Awata M, Sera F, Fujita M, Watanabe T, Iida O, et al. Arterial repair 4 months after zotarolimus-eluting stent implantation observed on angioscopy. Circ J. 2013;77:1186–92.

    Article  PubMed  Google Scholar 

  15. Akazawa Y, Matsuo K, Ueda Y, Nishio M, Hirata A, Asai M, et al. Atherosclerotic change at one year after implantation of Endeavor zotarolimus-eluting stent vs. everolimus-eluting stent. Circ J. 2014;78:1428–36.

    Article  PubMed  Google Scholar 

  16. Ueda Y, Matsuo K, Nishimoto Y, Sugihara R, Hirata A, Nemoto T, et al. In-stent yellow plaque at 1 year after implantation is associated with future event of very late stent failure: the DESNOTE study (detect the event of very late stent failure from the drug-eluting stent not well covered by neointima determined by angioscopy). J Am Coll Cardiol Intv. 2015;8:814–21. The presence of yellow plaque at one year after DES implantation was associated with future event of DES failure by a prospective study, suggesting atherosclerosis progression as a major cause of very-late DES failure.

    Article  Google Scholar 

  17. Kurihara O, Takano M, Yamamoto M, Shirakabe A, Kimata N, Inami T, et al. Impact of prediabetic status on coronary atherosclerosis: a multivessel angioscopic study. Diabetes Care. 2013;36:729–33.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  18. Ueda Y, Matsuo K, Nishio M, Hirata A, Asai M, Nemoto T, et al. The level of blood thrombogenicity was not elevated in stable patients with disrupted coronary plaque. J Cardiol. 2013;61:326–9.

    Article  PubMed  Google Scholar 

  19. Hirayama A, Saito S, Ueda Y, Takayama T, Honye J, Komatsu S, et al. Qualitative and quantitative changes in coronary plaque associated with atorvastatin therapy. Circ J. 2009;73:718–25.

    Article  CAS  PubMed  Google Scholar 

  20. Takayama T, Hiro T, Ueda Y, Honye J, Komatsu S, Yamaguchi O, et al. Plaque stabilization by intensive LDL-cholesterol lowering therapy with atorvastatin is delayed in type 2 diabetic patients with coronary artery disease-serial angioscopic and intravascular ultrasound analysis. J Cardiol. 2013;61:381–6.

    Article  PubMed  Google Scholar 

  21. Matsuo K, Ueda Y, Tsujimoto M, Hao H, Nishio M, Hirata A, et al. Ruptured plaque and large plaque burden are risks of distal embolisation during percutaneous coronary intervention: evaluation by angioscopy and virtual histology intravascular ultrasound imaging. EuroIntervention. 2013;9:235–42.

    Article  PubMed  Google Scholar 

  22. Ishihara T, Iida O, Awata M, Nanto K, Nanto S, Uematsu M. Angioscopic assessment of early phase arterial repair after paclitaxel-coated nitinol drug-eluting stent implantation in the superficial femoral artery. Circ J. 2013;77:1838–43.

    Article  CAS  PubMed  Google Scholar 

  23. Park SJ, Kang SJ, Virmani R, Nakano M, Ueda Y. In-stent neoatherosclerosis: a final common pathway of late stent failure. J Am Coll Cardiol. 2012;59:2051–7.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Cardiovascular Division, Osaka National Hospital, 2-1-14 Hoenzaka, Chuo-ku, Osaka, 540-0006, Japan

    Yasunori Ueda

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  1. Yasunori Ueda
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Correspondence to Yasunori Ueda.

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Yasunori Ueda reports personal fees from Abbott Vascular Japan, outside the submitted work.

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This article does not contain any studies with human or animal subjects performed by the author.

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This article is part of the Topical Collection on Intravascular Imaging

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Ueda, Y. Angioscopy in 2015: the Role of Macroscopic Pathology in Living Patients. Curr Cardiovasc Imaging Rep 9, 5 (2016). https://doi.org/10.1007/s12410-015-9367-4

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  • DOI: https://doi.org/10.1007/s12410-015-9367-4

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