Assessment of vasa vasorum on plaque components and no-reflow phenomenon by intravascular ultrasound and iMap analysis

Author:

Wu Xi1,Cai Xin-Yu1,Wang Quan1,Ji Gang1,Yan Yan1,Song Jing1,Chen Jing1,Huang He1

Affiliation:

1. Xiangtan Central Hospital

Abstract

Abstract Purpose Previously, researches have revealed that vasa vasorum (VV) neovascularisation is vital for the progression and vulnerability of coronary atherosclerosis plaque. Our team explored plaque constituents in iMap-intravascular ultrasound (iMap-IVUS) and no-reflow phenomenon (NRP) in the course of percutaneous coronary intervention (PCI) for lesions with VV. Methods Our team studied 385 coronary lesions in 361 patients (169 lesions with VV) undergoing pre-intervention IVUS. The diversities in plaque morphological status and post-PCI results were evaluated as per the presence or absence of VV. Results Lesions with VV were more frequently identified in acute coronary syndrome (ACS) patients (69.8% vs. 22.2%, P < 0.001).Plaques at the minimum lumen area, necrotic core area (1.24 ± 0.53mm2 vs. 1.24 ± 0.53mm2, P < 0.001;17.13 ± 6.67% vs.17.13 ± 6.67%, P < 0.001) and fibrous area (4.30 ± 0.90mm2 vs. 4.09 ± 1.00mm2, P = 0.033; 60.29 ± 8.24% vs. 58.04 ± 12.29%, P = 0.041) were considerably larger in the lesion with VV than in the lesion without VV. In addition,densely calcified plaques (0.40 ± 0.24mm2 vs. 0.79 ± 0.63mm2, P < 0.001; 5.72 ± 3.23% vs.11.63 ± 10.06%, P < 0.001) were considerably smaller in the lesion with VV than in the lesion without VV. Multivariate analyses revealed that VV and plaque volume were independent prediction factors of NRP posterior to stent deployment (odds ratio 0.091, 95% CI 0.039–0.210, P <0.001;odds ratio 0.949, 95% CI 0.921–1.979, P = 0.001). Conclusions Lesions with VV displayed great plaque vulnerability and were more frequently identified in ACS patients,, and they displayed more NRP in the course of PCI in contrast to lesions without VV. Multivariate analyses revealed that VV and plaque volume were independent prediction factors of NRP posterior to stent deployment.

Publisher

Research Square Platform LLC

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