• As a rule, percutaneous coronary intervention (PCI) with drug-eluting stent implantation for every intermediate lesion could increase the risk of stent thrombosis or restenosis, whereas deferral revascularization of high-risk intermediate lesions might be associated with a higher risk of long-term events [ 5 , 6 ]. (hindawi.com)
  • This may increase vulnerability to plaque rupture and thrombosis, with subsequent clinical sequelae. (bmj.com)
  • Pilot pathological studies have identified the pathophysiological processes implicated in the destabilisation and thrombosis of atheromatous plaques. (ecrjournal.com)
  • 1-3 According to the current understanding of ACS, plaques with specific morphological characteristics are more prone to rupture and development of thrombosis, which subsequently leads to the clinical manifestation of ACS. (ecrjournal.com)
  • 1-3 Plaque rupture, the most frequent mechanism of coronary thrombosis, involves disruption of a thin fibrous cap that overlies a large necrotic core, causing the thrombogenic contents of the necrotic core to come into contact with the bloodstream and trigger thrombus formation. (ecrjournal.com)
  • Plaque erosion is defined as the presence of thrombosis in the absence of plaque thrombosis, often with absence of an endothelial layer at the thrombosed sites. (ecrjournal.com)
  • Plaques that are at high risk of undergoing acute thrombosis are called vulnerable plaques and bear morphological resemblance to the aforementioned plaques. (ecrjournal.com)
  • The capacity of macrophages to reduce overall plaque stability and to promote thrombosis is discussed in the article by Thorp et al. (atm-signaling.com)
  • The major adverse event rate was defined as death due to any cause, heart attack (myocardial infarction), clinically driven target lesion revascularization and limb loss (major amputation only) on the treated side(s). (europeanpharmaceuticalreview.com)
  • It can reliably predict the restenosis propensity and the clinical consequence of target lesion revascularisation (TLR). (ecrjournal.com)
  • Immune mechanisms are thought to play a pivotal role in atherosclerosis, 1, 2 and inflammatory mediators are thought to be instrumental in early atherosclerotic lesion formation, plaque progression, and plaque rupture. (bmj.com)
  • Here we show that SMC-specific deletion of Smad3 in a murine atherosclerosis model resulted in greater plaque burden, more outward remodelling and increased vascular calcification. (stanford.edu)
  • Background: Smooth muscle cells (SMC) transition into a number of different phenotypes during atherosclerosis, including those that resemble fibroblasts and chondrocytes, and make up the majority of cells in the atherosclerotic plaque. (stanford.edu)
  • Atherosclerosis is a common condition in which an accumulation of fat, named "plaque" builds up on the innermost walls of arteries, causing them to become narrow and restrict the blood flow to vital organs such as the heart and the brain. (ox.ac.uk)
  • If atherosclerosis involves lipid-driven inflammation, signatures of inflammation should be found on foamy macrophages within the plaques, but nothing had been found so far, leading to significant controversy in the field. (ox.ac.uk)
  • The Kennedy scientists aimed to find these patterns and used unbiased single cell biology approaches on over 22,000 immune cells from the plaques of patients who had undergone surgical carotid atherosclerosis removal. (ox.ac.uk)
  • The present study tests MRM in the quantification of aortic atherosclerosis over a broader range of lesion severity. (ox.ac.uk)
  • Moreover, VDR deletion increases atherosclerosis by enabling lipid-laden M2 monocytes to adhere, migrate, and carry cholesterol into the atherosclerotic plaque and by increasing macrophage cholesterol uptake and esterification. (regenerativemedicine.net)
  • 16 In addition, the management of patients with acute symptomatic carotid artery occlusion remains controversial, though the angiographic finding of ICA occlusion reveals a spectrum of ICA occlusions, as well as a tandem lesion in the intracranial artery in addition to the level (below or above the ophthalmic artery) and type (atherosclerotic or embolic) of lesion. (ajnr.org)
  • KAIZEN is a prospective, single-arm, multi-center study aimed at evaluating the safety and efficacy of the company's Diamondback 360 Peripheral OAS in the treatment of de novo symptomatic calcified occlusive atherosclerotic lesions in the superficial femoral artery and popliteal artery. (delveinsight.com)
  • The Supera™ Peripheral Stent System is indicated to improve luminal diameter in the treatment of patients with symptomatic de novo or restenotic native lesions or occlusions of the superficial femoral artery (SFA) and / or proximal popliteal artery with reference vessel diameters of 4.0 to 7.5 mm, and lesion lengths up to 140 mm. (cardiovascular.abbott)
  • Absolute Pro is a self-expanding nitinol stent system made of a flexible material designed to allow the stent to conform to challenging lesions. (europeanpharmaceuticalreview.com)
  • It incorporates advanced technologies for optimal stent visibility, with a delivery system that is designed to minimize friction during stent deployment and ensure precise stent placement at the lesion site. (europeanpharmaceuticalreview.com)
  • Patients were enrolled if they had de novo lesions with a visual estimation of lumen DS of 50-70% and without revascularization (balloon angioplasty and/or stent implantation) after IVUS examination. (hindawi.com)
  • In severely calcified coronary lesions, stent dilatation and maximum vessel wall apposition are frequently compromised. (icloudhospital.com)
  • High-pressure, non-compliant balloon inflations may still fail to sufficiently dilate and prepare a substantially calcified artery for stent delivery in situations with heavily calcified lesions. (icloudhospital.com)
  • The main indication for RA is the modification of substantially calcified de novo coronary stenosis that is unlikely to be sufficiently widened by balloon angioplasty to enable full stent expansion. (icloudhospital.com)
  • Patients who are judged to have a lesion that prevents complete inflation of an angioplasty balloon or proper placement of the stent or stent delivery system. (cardiovascular.abbott)
  • A pivotal randomised controlled trial (RCT) was the Randomized Study with the Sirolimus-coated Bx Velocity Balloon- Expandable Stent in the Treatment of Patients with De Novo Native Coronary Artery Lesions (RAVEL), 1 in which 238 patients were randomised to a single SES and a BMS. (ecrjournal.com)
  • This was followed by the larger (1,058 patients) Sirolimus-eluting Stent in De Novo Native Coronary Lesions (SIRIUS) trial 2 in the US, and the E-SIRIUS 3 (n=352) in Europe and C-SIRIUS 4 (n=100) in Canada. (ecrjournal.com)
  • In human atherosclerotic lesions, 2 main sources of Lp-PLA2 can be identified, including that which is brought into the intima bound to LDL (from the circulation), and that which is synthesized de novo by plaque inflammatory cells (macrophages, T cells, mast cells). (wikipedia.org)
  • Cryostat sections of atherosclerotic plaques were immunohistochemically stained with monoclonal antibodies: anti-CD68 (macrophages), anti-5G4 (CRP), aE11 (MAC), and 12E7 (oxLDL). (bmj.com)
  • A new type of macrophages recently identified in atherosclerotic lesions could provide a missing link in understanding the inflammatory origins of the common yet fatal condition. (ox.ac.uk)
  • The combined data from the last three studies (NEW-SIRIUS) reported a 5.1% in-lesion restenosis rate. (ecrjournal.com)
  • Intravascular ultrasound (IVUS) is superior to coronary angiography in terms of accurate assessment of lumen area and plaque burden and thus is commonly applied to evaluate intermediate stenotic lesions and guide the decision about revascularization in real-world practice [ 4 , 7 ]. (hindawi.com)
  • It took great courage around 30 years ago to tackle stenotic lesions within a diseased coronary artery using the percutaneous approach in an unanaesthetised human being. (ecrjournal.com)
  • C reactive protein (CRP), an important serum marker of atherosclerotic vascular disease, has recently been reported to be active inside human atherosclerotic plaques. (bmj.com)
  • Together, the findings reveal that Smad3 expression in SMC inhibits the emergence of specific SMC phenotypic transition cells that mediate adverse plaque features, including outward remodelling, monocyte recruitment, and vascular calcification. (stanford.edu)
  • On reaching the coronaries, the balloon was inflated to compress the atherosclerotic plaque against the vascular wall and restore blood flow to the myocardium. (statpearls.com)
  • Other stents like bifurcation stents and covered stents are designed for special circumstances such as lesion over vascular bifurcation or coronary artery perforation, respectively. (statpearls.com)
  • Consequently, OCT is a valuable research tool for examining the role of morphological characteristics of atheromatous plaques in the progression of coronary artery disease and plaque destabilisation, which leads to the clinical manifestation of ACS. (ecrjournal.com)
  • The specific pattern of gene expression also suggests that these cells are a culprit for disease progression by recruiting other immune cells to atherosclerotic plaques. (ox.ac.uk)
  • It is the most popular atherectomy tool and eliminates atheromatous plaque via differential cutting, which involves removing the inelastic calcified plaque with microscopic diamond chips implanted on the surface of a fast-revolving olive-shaped burr (150,000 to 200,000 rpm). (icloudhospital.com)
  • Morphological characteristics of the atheromatous plaque have been associated with the development of plaque rupture and the pathogenesis of acute coronary syndromes (ACS). (ecrjournal.com)
  • The vessel wall compliance in calcified or fibrotic lesions is increased by removing significant calcification or changing the calcified atherosclerotic plaque, and the lumen diameter obtained from using this device will be significantly better than that obtained from using straightforward balloon angioplasty. (icloudhospital.com)
  • n = 18) underwent directional coronary atherectomy for coronary lesions. (bmj.com)
  • Rotational atherectomy is a highly specialized catheterization operation used to remove plaque from an artery that has calcified to such an extent that it has narrowed or obstructed. (icloudhospital.com)
  • Rotational atherectomy is a procedure that unclogs calcified plaque from a coronary artery by dislodging it with a rotating tool called a Rotablator. (icloudhospital.com)
  • The aim of this study was to investigate the impact of arterial remodeling of intermediate coronary lesions on long-term clinical outcomes. (hindawi.com)
  • Furthermore, previous studies have shown that arterial remodeling assessed by IVUS in vivo affects hemodynamic stress on the lesion site [ 8 - 10 ] and is correlated with clinical presentation [ 11 , 12 ]. (hindawi.com)
  • Recent evidence suggests that the risk of clinical events is related not only to local factors within the atherosclerotic plaque (such as the state of the necrotic core or the fibrous cap), but also to blood-borne or systemic factors. (medscape.com)
  • Stimulated by the remarkable results of the initial studies, cardiologists have progressively expanded the use of SES to almost all clinical situations and more complex lesions. (ecrjournal.com)
  • HTA groups such as NICE and ANAES (Agence Nationale d'Accreditation et d'Evaluation en Sante) in France are seen as being much more influential since they impact on clinical practice and reimbursement. (bmj.com)
  • In addition to its role in ATP synthesis, mitochondrial coenzyme Q 10 mediates the oxidation of dihydroorotate to orotate in the de novo pyrimidine synthesis. (oregonstate.edu)
  • Risk stratification and management strategy of intermediate coronary lesions, defined as 50-70% diameter stenosis (DS) at coronary angiography [ 1 , 2 ], remain a challenging issue [ 3 , 4 ]. (hindawi.com)
  • Intracoronary imaging techniques can assess coronary plaques beyond luminal assessment (i.e. coronary angiography) and can visualise atheromatous plaques in vivo . (ecrjournal.com)
  • Monocyte migration to the vessel wall is a key event in the growth of atherosclerotic lesions. (atm-signaling.com)
  • Smad3 regulates smooth muscle cell fate and mediates adverse remodeling and calcification of the atherosclerotic plaque. (stanford.edu)
  • Considerable atherosclerotic coronary artery disease (CAD) is correlated with significant calcification. (icloudhospital.com)
  • When there is severe calcification, RA can be employed as a primary technique or as a backup plan if coronary angioplasty fails to widen a lesion. (icloudhospital.com)
  • Plaques with a specific morphological phenotype that are at high risk of causing ACS are called vulnerable plaques, and can be identified in vivo through the use of intracoronary imaging. (ecrjournal.com)
  • Atherosclerotic lesions in genetically modified mice quantified in vivo by non-invasive high-resolution magnetic resonance microscopy. (ox.ac.uk)
  • This work was funded by a variety of national and international agencies including the European Commission, the Novo Nordisk Foundation, the British Heart Foundation, the Leducq Foundation for Cardiovascular research the Swedish Research Council, the Swedish Heart and Lung Foundation, Diabetes Research and the Oxford NIHR Biomedical Research Centre. (ox.ac.uk)
  • This article summarises the pathophysiological insights obtained by OCT imaging in the formation and rupture of the vulnerable plaque. (ecrjournal.com)
  • The Diamondback 360 Peripheral OAS is used for the treatment of calcified plaque in patients with peripheral artery disease (PAD). (delveinsight.com)
  • Peripheral artery disease (PAD) affects approximately 8 million to 12 million people in the U.S.[1] and occurs when the blood vessels outside of the heart become narrowed with plaque, fatty deposits that build up within the vessels. (europeanpharmaceuticalreview.com)
  • Aortoiliac occlusive disease (AIOD), more commonly known as iliac artery disease, occurs when the iliac arteries become narrowed with plaque, resulting in reduced blood flow to the lower limbs. (europeanpharmaceuticalreview.com)
  • Accordingly, we sought to investigate the impact of arterial remodeling of intermediate lesions on long-term prognosis in patients with stable coronary artery disease. (hindawi.com)
  • The presence of CRP, complement, and oxLDL in a high proportion of plaque tissue from patients with unstable coronary artery disease implies that these surrogate markers have important proinflammatory effects inside atherosclerotic plaques. (bmj.com)
  • Smooth muscle cells (SMCs), the major cell type in atherosclerotic plaques, are vital in coronary artery diseases (CADs). (stanford.edu)
  • The functional relevance of a select few novel lncRNAs were verified in vitro.We identified 4579 known and 13 655 de novo lncRNAs in human coronary artery SMC. (stanford.edu)
  • Atherosclerotic plaques consist mostly of smooth muscle cells (SMC), and genes that influence SMC phenotype can modulate coronary artery disease (CAD) risk. (stanford.edu)
  • The on-label indications for the Cypher SES were single de novo lesions in patients with stable coronary artery disease (CAD) in vessels with reference diameters between 2.5 and 3.5mm and in lesions ≤30mm. (ecrjournal.com)
  • Treatment of coronary intermediate lesions remains a controversy, and the role of arterial remodeling patterns determined by intravascular ultrasound in intermediate lesion is still not well known. (hindawi.com)
  • Optical coherence tomography (OCT) is a high-resolution intravascular imaging modality that enables detailed visualization of atheromatous plaques. (ecrjournal.com)
  • 4 Among these techniques, due to its high resolution (~15 μm) optical coherence tomography (OCT) can identify the majority of the morphological characteristics of stable and complicated atheromatous plaques, including precise measurement of the thickness of the overlying fibrous plaque and a high sensitivity for thrombus detection. (ecrjournal.com)
  • Remarkable progress has been achieved in the understanding of pathogenesis, risk factors for CAV and plaque morphology. (lidsen.com)
  • The atherosclerotic process may gradually progress to complete occlusion of medium-sized and large arteries. (medscape.com)
  • The dynamic changes in expression of these lncRNAs correspond to alterations in transcriptional programs that are relevant to CAD, suggesting a critical role for lncRNAs in SMC phenotypic transition and human atherosclerotic disease. (stanford.edu)
  • Now thanks to the revolutionary development of single cell biology, which gives us a snapshot of the transcriptional states of all cells of the human plaque and the painstaking attention to detail of first authors Lea and Lada, we were able to "catch them in the act" and gain clues about their development in the atherosclerotic environment through pattern recognition receptors. (ox.ac.uk)
  • Arterial remodeling patterns were assessed in 212 deferred intermediate lesions from 162 patients after IVUS examination. (hindawi.com)
  • 72 intermediate remodeling lesions were present in 66 patients, whereas 77 negative remodeling lesions were present in 71 patients, and 63 positive remodeling lesions were present in 55 patients. (hindawi.com)
  • There is also a possibility of unrecognized intimal dissection when doing RA in a lesion that has received aggressive balloon angioplasty, albeit this is uncommon. (icloudhospital.com)
  • It is a minimally invasive, single-use, catheter-based device capable of differentiating between hard, diseased plaque and healthy, compliant arterial tissue. (delveinsight.com)
  • The OAS orbiting crown reduces and modifies calcified plaque along with preserving the healthy vessel wall to restore blood flow. (delveinsight.com)
  • These data provide further evidence for the novo mechanism of atorvastatin's pleiotropic effect. (biomedcentral.com)
  • Plaques are easily seen, as well as the difference between vessel wall and flowing blood. (medscape.com)
  • Recently, CRP was identified within early atherosclerotic lesions in human coronary arteries obtained at necropsy. (bmj.com)
  • In our center, IVUS was routinely used to assess the angiographically intermediated lesions. (hindawi.com)
  • Smooth muscle cell (SMC) phenotypic transition, which leads to the formation of various cell types in atherosclerotic plaques, is regulated by a network of genetic and epigenetic mechanisms and governs the risk of disease. (stanford.edu)
  • Preferential activation of microsomal diacylglycerol/protein kinase C signaling during glucose treatment (De Novo phospholipid synthesis) of rat adipocytes. (jci.org)
  • Glucose has been reported to increase the de novo synthesis of diacylglycerol (DAG) and translocate and activate protein kinase C (PKC) in rat adipocytes. (jci.org)
  • A characteristic feature of the atherosclerotic process in its course is a significant intensity. (medsci.org)