Abstract 16399: The Association Between the Volume of Lipid-rich Plaque and the Amount of Debris Captured by a Filter-Type Distal Protection Device in Patients After Coronary Stent Implantation
Background Disruption of atherosclerotic plaque by balloon or stent expansion and distal embolism may be a major cause of periprocedural myocardial injury during percutaneous coronary intervention (PCI). However, the relationship between lesion characteristics and the amount of plaque particles released during the procedure is unclear.
Methods Between April 2010 and December 2011, we enrolled 45 consecutive patients who underwent coronary stent implantation with a filter-type distal protection device (Filtrap™, Nipro, Japan) following integrated backscatter intravascular ultrasound (IB-IVUS) analysis. The volumes of each plaque component (lipid; fibrous and calcified plaques) within the target lesion were calculated. The area of the debris captured by the protection filter was measured by microscopic evaluation (Figure).
Results The lipid volume was significantly correlated with the area of the captured debris (r = 0.589, p < 0.01). The volumes of either the fibrous or calcified plaques did not correlate with the area of the captured debris. Although the lipid volume fraction correlated positively with the amount of captured debris (r = 0.437, p < 0.01), the fibrous volume fraction was found to be inversely correlated (r = -0.426, p < 0.01). Through multivariate regression analysis after adjusting for clinical and procedural parameters and other plaque components, we found that the lipid volume was independently correlated with the area of captured debris.
Conclusion The volume of lipid-rich plaque was associated with the amount of procedure-related debris released and captured by the filter device. These findings provide insights into the mechanisms of distal embolism during PCI.
- © 2012 by American Heart Association, Inc.