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Images in Interventional Cardiology

Embolization of Neoatherosclerosis After Percutaneous Coronary Intervention

Insights From Near-Infrared Spectroscopy Imaging and Histopathological Analysis

Kensaku Nishihira, Fumiyuki Otsuka, Yu Kataoka, Yasuhide Asaumi, Kohei Kaneta, Hiroki Nakano, Keiko Ohta-Ogo, Hatsue Ishibashi-Ueda, Teruo Noguchi, Satoshi Yasuda
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https://doi.org/10.1161/CIRCINTERVENTIONS.117.006175
Circulation: Cardiovascular Interventions. 2018;11:e006175
Originally published February 14, 2018
Kensaku Nishihira
From the Department of Cardiovascular Medicine (K.N., F.O., Y.K., Y.A., K.K., H.N., T.N., S.Y.) and Department of Clinical Pathology (K.O.-O., H.I.-U.), National Cerebral and Cardiovascular Center, Suita, Japan.
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Fumiyuki Otsuka
From the Department of Cardiovascular Medicine (K.N., F.O., Y.K., Y.A., K.K., H.N., T.N., S.Y.) and Department of Clinical Pathology (K.O.-O., H.I.-U.), National Cerebral and Cardiovascular Center, Suita, Japan.
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Yu Kataoka
From the Department of Cardiovascular Medicine (K.N., F.O., Y.K., Y.A., K.K., H.N., T.N., S.Y.) and Department of Clinical Pathology (K.O.-O., H.I.-U.), National Cerebral and Cardiovascular Center, Suita, Japan.
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Yasuhide Asaumi
From the Department of Cardiovascular Medicine (K.N., F.O., Y.K., Y.A., K.K., H.N., T.N., S.Y.) and Department of Clinical Pathology (K.O.-O., H.I.-U.), National Cerebral and Cardiovascular Center, Suita, Japan.
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Kohei Kaneta
From the Department of Cardiovascular Medicine (K.N., F.O., Y.K., Y.A., K.K., H.N., T.N., S.Y.) and Department of Clinical Pathology (K.O.-O., H.I.-U.), National Cerebral and Cardiovascular Center, Suita, Japan.
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Hiroki Nakano
From the Department of Cardiovascular Medicine (K.N., F.O., Y.K., Y.A., K.K., H.N., T.N., S.Y.) and Department of Clinical Pathology (K.O.-O., H.I.-U.), National Cerebral and Cardiovascular Center, Suita, Japan.
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Keiko Ohta-Ogo
From the Department of Cardiovascular Medicine (K.N., F.O., Y.K., Y.A., K.K., H.N., T.N., S.Y.) and Department of Clinical Pathology (K.O.-O., H.I.-U.), National Cerebral and Cardiovascular Center, Suita, Japan.
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Hatsue Ishibashi-Ueda
From the Department of Cardiovascular Medicine (K.N., F.O., Y.K., Y.A., K.K., H.N., T.N., S.Y.) and Department of Clinical Pathology (K.O.-O., H.I.-U.), National Cerebral and Cardiovascular Center, Suita, Japan.
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Teruo Noguchi
From the Department of Cardiovascular Medicine (K.N., F.O., Y.K., Y.A., K.K., H.N., T.N., S.Y.) and Department of Clinical Pathology (K.O.-O., H.I.-U.), National Cerebral and Cardiovascular Center, Suita, Japan.
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Satoshi Yasuda
From the Department of Cardiovascular Medicine (K.N., F.O., Y.K., Y.A., K.K., H.N., T.N., S.Y.) and Department of Clinical Pathology (K.O.-O., H.I.-U.), National Cerebral and Cardiovascular Center, Suita, Japan.
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  • drug-eluting stents
  • humans
  • lipids
  • pathology
  • spectroscopy, near-infrared

Introduction

An 85-year-old man was hospitalized because of ST-segment–elevation myocardial infarction 145 months after the implantation of sirolimus-eluting Cypher stent. Emergent coronary angiography identified in-stent restenosis at the body of sirolimus-eluting Cypher stent in the proximal right coronary artery (Figure [A]). Optical coherence tomography visualized rupture of lipidic neointima potentially containing cholesterol crystals (Figure [B]). Near-infrared spectroscopy (NIRS) combined with intravascular ultrasound showed extensive yellow signals indicating lipid accumulation, potentially both within and outside the stent, with a high, maximum 4-mm lipid core burden index with 880 (Figure [C] and [D]). After an implantation of cobalt–chromium everolimus-eluting stent, no-reflow phenomenon with thrombolysis in …

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Circulation: Cardiovascular Interventions
February 2018, Volume 11, Issue 2
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    Embolization of Neoatherosclerosis After Percutaneous Coronary Intervention
    Kensaku Nishihira, Fumiyuki Otsuka, Yu Kataoka, Yasuhide Asaumi, Kohei Kaneta, Hiroki Nakano, Keiko Ohta-Ogo, Hatsue Ishibashi-Ueda, Teruo Noguchi and Satoshi Yasuda
    Circulation: Cardiovascular Interventions. 2018;11:e006175, originally published February 14, 2018
    https://doi.org/10.1161/CIRCINTERVENTIONS.117.006175

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    Embolization of Neoatherosclerosis After Percutaneous Coronary Intervention
    Kensaku Nishihira, Fumiyuki Otsuka, Yu Kataoka, Yasuhide Asaumi, Kohei Kaneta, Hiroki Nakano, Keiko Ohta-Ogo, Hatsue Ishibashi-Ueda, Teruo Noguchi and Satoshi Yasuda
    Circulation: Cardiovascular Interventions. 2018;11:e006175, originally published February 14, 2018
    https://doi.org/10.1161/CIRCINTERVENTIONS.117.006175
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