17 research outputs found
Percutaneous Coronary Intervention (PCI) Strategies under Hemodynamic Support for Cardiogenic Shock: A Single-Center Experience with Two Patients
We describe two cases of profound cardiogenic shock complicating acute myocardial infarction (CSAMI) requiring mechanical circulatory support (MCS) with venoarterial extracorporeal membrane oxygenation (VA-ECMO) allowing complex, high-risk, and staged percutaneous interventions with successful decannulation but with unfortunate outcomes
The histological analysis of the coronary medial thickness: Implications for percutaneous coronary intervention.
BackgroundA deeper understanding of coronary medial thickness is important for coronary intervention because media thickness can limit the safety and effectiveness of interventional techniques. However, there is a paucity of detailed data on human coronary medial thickness so far.Materials and methodsWe investigated the thickness of the media by histologic analysis. A total of 230 sections from 10 individuals from the CVPath autopsy registry who died from non-coronary deaths were evaluated. We performed pathological analysis on 13 segments of the following primary vessels from coronary arteries: the left main trunk, proximal left anterior descending artery (LAD), mid LAD, distal LAD, proximal left circumflex artery (LCX), mid LCX, distal LCX, proximal right coronary artery (RCA), mid RCA, and the distal RCA. The following side branches were also evaluated: diagonal, obtuse margin, and posterior descending artery branches.ResultsThe average age of the studied individuals was 60.4±12.3 years. The median medial thickness for all sections was 0.202 (0.149-0.263) mm. The median medial thickness of the main branches was significantly higher compared to that of the side branches (pConclusionsThe human coronary arteries demonstrate variation in medial thickness which tends to vary depending upon an epicardial coronary artery itself, as well as its segments and branches. Understanding these variations in medial thickness can be useful for both the interventionalists and interventional product development teams
Patient and lesion characteristics.
BackgroundA deeper understanding of coronary medial thickness is important for coronary intervention because media thickness can limit the safety and effectiveness of interventional techniques. However, there is a paucity of detailed data on human coronary medial thickness so far.Materials and methodsWe investigated the thickness of the media by histologic analysis. A total of 230 sections from 10 individuals from the CVPath autopsy registry who died from non-coronary deaths were evaluated. We performed pathological analysis on 13 segments of the following primary vessels from coronary arteries: the left main trunk, proximal left anterior descending artery (LAD), mid LAD, distal LAD, proximal left circumflex artery (LCX), mid LCX, distal LCX, proximal right coronary artery (RCA), mid RCA, and the distal RCA. The following side branches were also evaluated: diagonal, obtuse margin, and posterior descending artery branches.ResultsThe average age of the studied individuals was 60.4±12.3 years. The median medial thickness for all sections was 0.202 (0.149–0.263) mm. The median medial thickness of the main branches was significantly higher compared to that of the side branches (pConclusionsThe human coronary arteries demonstrate variation in medial thickness which tends to vary depending upon an epicardial coronary artery itself, as well as its segments and branches. Understanding these variations in medial thickness can be useful for both the interventionalists and interventional product development teams.</div
Representative images of sections with different degrees of luminal narrowing.
A, B. Representative images of the sections in the left circumflex artery in a 63-year-old male. The vessel diameters are almost similar between A (3.31mm) and B (3.39 mm). However, the luminal narrowing and medial thickness are measured as (A) 60.0% and 0.217 mm and (B) 19.0%, and 0.324 mm, respectively.</p
Measurements of the vessel diameter and the medial thickness.
Measurements of the vessel diameter and the medial thickness.</p
The comparison of the medial thicknesses between main and side branches.
The median thickness of the media in the main branches was significantly higher than in the side branches (0.214 mm [0.157–0.281mm] vs 0.159 mm [0.133–0.204 mm], respectively, p<0.001).</p
The comparison of the medial thicknesses between proximal, mid, and distal segments of LAD, LCX, and RCA.
A. The medial thickness of the main branch of LAD became lower from proximal to distal segments (p = 0.010). B. The medial thickness of the main branch of LCX became lower from proximal to distal segments (p = 0.006). C. The medial thickness of the main branch of RCA did not significantly become lower from the proximal to distal segments (p = 0.170). LAD, left anterior descending artery; PLAD, proximal LAD; MLAD, mid LAD; DLAD, distal LAD. LCX, left circumflex artery; PLC, proximal LCX; MLC, mid LCX; DLC, distal LCX. RCA, right coronary artery; PRC, proximal RCA; MRC, mid RCA; DRC, distal RCA.</p
The comparison of the tapered ratio of the main branches.
The comparison of the tapered ratio of the main branches.</p