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82-year-old man with calcified stenosis in left main artery who underwent coronary CTA by PCD CT. Curved multiplanar reformatted images at varying virtual monoenergetic imaging (VMI) levels (40-140 keV) show stenosis at each level. Percent diameter stenosis (PDS) decreased from 92.5% at 40 keV to 53.1% at 140 keV. at 140 keV.
Thus, it has recently become generally accepted that most plaque ruptures resulting in myocardial infarction occur in plaques that narrow the lumen diameter by 40% of the arterial cross section may be involved by plaque. The pathologist may see a plaque that constitutes, for example, 50% of the cross-sectional area.
mm (green outline) section thickness show the respective calcified plaque (arrowheads) and coronary stenosis (inset images). The reduced section thickness leads to less calcium blooming and therefore a less severe assessment of percentage of coronary stenosis in this patient. Curved multiplanar reconstructions with 0.6-mm
These key takeaways from the research letter on IVL-facilitated valvuloplasty for severely calcified mitral valve stenosis are published in the Journal of the American College of Cardiology (JACC) Cardiovascular Interventions. We are looking forward to treating patients who have no other options for mitral stenosis diseased valves.”
Getty Images milla1cf Mon, 06/10/2024 - 18:02 June 10, 2024 — New expert consensus from the Society of Cardiovascular Computed Tomography (SCCT) reviews previously published qualitative and semi-quantitative measurements – including clinical guidelines like CAD-RADS 2.0
Stroke, Volume 55, Issue Suppl_1 , Page AWMP61-AWMP61, February 1, 2024. Background:Assessing carotid artery plaques in stenosis is crucial for treatment strategies and safety. We investigated the utility of CEST-MRI as a preoperative plaque diagnostic tool.Methods:APT imaging evaluated plaques prior to the procedures.
Stroke, Volume 55, Issue Suppl_1 , Page AWP116-AWP116, February 1, 2024. Ipsilateral and contralateral carotid artery plaque features were compared, then the carotid artery plaque characteristics on the infarct side were correlated with the infarct pattern.Results:the mean age of subjects included was 68 years old, 79.6%
Image courtesy: Getty Images christine.book Tue, 06/18/2024 - 11:07 June 18, 2024 — Elixir Medical has announced the company’s novel bioadaptive implant, DynamX Sirolimus-Eluting Coronary Bioadaptor System, has been granted Breakthrough Device Designation by the U.S. of the U.S. population. versus 5.5%; p=0.046) respectively.
tim.hodson Fri, 11/08/2024 - 13:23 Nov. 4, 2024 — Royal Philips recently announced enrollment of the first patient in the U.S. THOR IDE clinical trial, which will study an innovative combined laser atherectomy and intravascular lithotripsy catheter that integrates two critical PAD treatments into a single device.
Stroke, Volume 55, Issue Suppl_1 , Page ATP176-ATP176, February 1, 2024. Background:High-risk non-stenosing carotid plaque features are emerging as a possible source of embolism in the setting of ESUS.
Stroke, Volume 55, Issue 2 , Page 311-323, February 1, 2024. The risk of stroke recurrence among patients with ICAD-related stroke is the highest among those with confirmed stroke and stenosis ≥70%. Intracranial atherosclerotic disease (ICAD) is one of the most common causes of stroke worldwide.
Stroke, Volume 55, Issue Suppl_1 , Page A42-A42, February 1, 2024. Introduction:A new Plaque-RADS classification (I-IV) is proposed to categorize the degree of carotid plaque instability and risk of embolic ischemic stroke. Carotid total plaque thickness and ulceration were scored by a neuroradiologist blinded to stroke side.
25, 2024 in the European Heart Journal Cardiovascular Imaging. 25, 2024 in the European Heart Journal Cardiovascular Imaging 1. 25, 2024 in the European Heart Journal Cardiovascular Imaging 1. In Press European Heart Journal CV Imag 2024.This With Plaque Features Associated with False Positives. James Min, M.D.
Lp(a) is emerging as an important, yet under-recognized, potential risk factor for cardiovascular disease due to its ability to promote the development of plaques within artery walls, clot formation and aortic valve calcification. 2024 May-Jun;18(3):e308-e319. 2022 Aug, 80 (9) 934946 Kronenberg F. J Clin Lipidol. doi: 10.1016/j.jacl.2024.03.001.
A study published in Radiology , the flagship journal of the Radiological Society of North America evaluated both in vivo and in vitro coronary stenosis using ultrahigh-spatial-resolution photon counting detector CT reconstructions [1]. 2024 Feb;310(2):e231956. Section increments were 0.4 mm and 0.1 mm respectively.
Angiography : --Culprit for the patient's unstable angina/Wellen syndrome is a ruptured plaque in the mid LAD. --As In my experience — this ECG pattern is less specific for high-grade LAD stenosis, because other entities ( including non-cardiac CNS conditions ) may also be associated with symmetric T wave inversion.
The LAD has diffuse disease with a few areas of moderate stenosis but no flow-limiting lesions. Although it is statistically unlikely, multiple plaque ruptures are possible. The PDA plaque was also bulky, but was not described as inflamed or ulcerated. The distal LCx is seen, and the OM is not well visualized here.
Stroke, Volume 55, Issue Suppl_1 , Page A36-A36, February 1, 2024. Methods:This multicenter, observational study recruited first-ever acute ischemic stroke patients attributed to ICAS (>50% stenosis or occlusion) within 7 days after onset. The plaque length (5.69±2.21 mm), plaque burden (78.40±7.37% 7.37% vs. 78.22±8.32%),
At ADN CoE, we recently organized a comprehensive CT Complete Experience training, which took place on April 20-21, 2024. In the dynamic realm of medical imaging, continuous education and training are essential to honing the skills of healthcare professionals.
Circulation, Volume 149, Issue 3 , Page 251-266, January 16, 2024. Nevertheless, the relationship between CAC and the susceptibility of a plaque to provoke a thrombotic event remains incompletely understood. Limited spatial resolution and blooming artifacts may hinder estimation of degree of coronary artery stenosis.
The scan did not find PE, but showed evidence of coronary plaque: There are areas of dense white in the LAD (red and blue circles) and in the first diagonal (green circle). The red arrow shows a roughly 80% stenosis of the proximal LAD. The blue arrow shows another stenosis of the LAD distal to the first diagonal branch of about 99%.
Circulation, Volume 150, Issue Suppl_1 , Page A4142716-A4142716, November 12, 2024. Background:Heavily calcified coronary bifurcation lesions present significant challenges during percutaneous coronary intervention, particularly during atherectomy due to the risk of side branch occlusion from plaque shift.
At ADN CoE, we recently organized a comprehensive CT Complete Experience training, which took place on April 20-21, 2024. In the dynamic realm of medical imaging, continuous education and training are essential to honing the skills of healthcare professionals.
Stroke, Volume 55, Issue Suppl_1 , Page ATMP68-ATMP68, February 1, 2024. Symptomatic stenosis (63.9% Purpose:Since the balloon protection device became unavailable in Japan three years ago, the DWI-positive rate after carotid artery stenting (CAS) has increased. vs. 94.7%, p<0.05) was more common in the with-POWER group.
Image courtesy: ACC christine.book Thu, 02/29/2024 - 11:22 February 29, 2024 — The American College of Cardiology ( ACC ) will soon be holding its ACC 73rd Annual Scientific Session & Expo , ACC.24 24 from April 6 - 8, 2024 in Atlanta, GA at the Georgia World Congress Center.
The cardiologist called this 20% stenosis. Smith comment : a very high proportion of MINOCA are ruptured plaque with lysed thrombus. That plaque is at risk of thrombosing again. It is worthwhile remembering that the majority of plaques which rupture are non-obstructive before they ulcerate and thrombose.
Circulation, Volume 150, Issue Suppl_1 , Page A4119169-A4119169, November 12, 2024. PCI has become a common treatment of chronic total occlusion, and techniques continue to be developed to tackle more challenging cases. The patient was advised CABG by the heart team, but the patient refused, and PCI was attempted on a shared decision basis.
The CaRi-Plaque technology supports non-invasive analysis of coronary anatomy and pathology from routine coronary computed tomography angiography (CCTA) scans to determine the presence, extent and severity of coronary plaques and luminal stenosis (narrowing of arteries). But with AI, we can change that.
Coronary computed tomography angiography (CCTA) was a major advancement in CAD diagnostics, helping physicians estimate if a stenosis was significant and requiring intervention. Now Heartflow Plaque Analysis leverages AI to quantify and characterize the amount and type of plaque present in the arteries from a single CCTA scan.
About a fifth of all ischemic strokes are attributed to embolization of ruptured atherosclerotic plaque from carotid arterial stenosis. But it has been difficult to predict which person with asymptomatic carotid artery stenosis is likely to progress to symptomatic carotid disease and stroke. 2024 May 7;83(18):1728-1730.
6 This novel study marks a significant milestone in the field, evaluating the effectiveness of FFR CT in detecting ischemia-producing coronary stenosis in patients with severe PAD. 2024, [link]. 5 Revascularization to improve blood flow to the heart has been shown to reduce mortality in stable chest pain patients. 101272, [link].
The Neuroguard Integrated Embolic Protection (IEP) system is an experimental treatment for carotid artery stenosis, also known as carotid artery disease, a condition in which fatty-waxy deposits known as plaque builds up and blocks the normal flow of blood in the large arteries on either side of the neck.
The American College of Cardiology (ACC) held its 73 rd annual scientific session and expo April 6-8, 2024 in Atlanta, Georgia. SMART 4 ( NCT04722250 ) studied patients with severe aortic stenosis and a small aortic annulus who underwent transcatheter aortic valve replacement (TAVR). Here is our curated list of the top sessions.
Stroke, Volume 55, Issue 2 , Page 269-277, February 1, 2024. BACKGROUND:Sex-specific differences in plaque composition and instability underscore the need to explore circulating markers for better prediction of high-risk plaques. Plaque stability was determined by gold-standard histological classifications.
Stroke, Volume 55, Issue Suppl_1 , Page ATP143-ATP143, February 1, 2024. Previous studies demonstrated bilateral symmetry in atherosclerotic plaque burden and calcification scores. Within each artery, the range of slices with wall thickness > 2mm on any scan was included as potential atherosclerotic plaque. scans over 5.2
Getty Images milla1cf Thu, 01/25/2024 - 20:44 January 25, 2024 — Agepha Pharma , a leading multinational pharmaceutical company with the first FDA-approved anti-inflammatory cardiovascular treatment ( LODOCO – colchicine, 0.5 More than 8 million Americans visit hospital emergency departments experiencing chest pain every year.
There are multiple possible clinical situations that could account for diffuse subendocardial ischemia that is not due to ACS and plaque rupture. Below is a still image with the red arrow indicating the subtotal LMCA stenosis. The video below shows the coronary angiography. Pressors could gradually be tapered within 24 hours.
In addition, the top left blue arrow indicates a section in the LAD with a severe stenosis, likely the culprit for the prior L A D occlusion which has since recanalized. As an aside, the LCx OMI is a type 2 event, since it is due to supply-demand mismatch from thrombus, and not due to atherosclerotic plaque rupture or erosion).
Top 10 Clinical Trials Preventive PCI on Stenosis With Functionally Insignificant Vulnerable Plaque PREVENT (ACC.24) 24 and TCT 2024) Colchicine in AMI CLEAR SYNERGY (OASIS 9) (TCT 2024 and AHA 2024) Semaglutide Treatment Effect in People With Obesity and HFpEF and Diabetes Mellitus STEP-HFpEF DM (ACC.24)
Provocative testing is very helpful for this Coronary Thrombus with lysis (one must do optical coherence tomography or at least intravascular ultrasound to find thes non-obstructive plaques that ruptured. For more on the ECG diagnosis and consequences of acute RV MI Check out My Comment in July 19, 2020 post and the August 2, 2024 post).
High Lp(a) is a causal risk factor for atherosclerotic cardiovascular disease (ASCVD), aortic stenosis, and all-cause mortality. Elevated Lp(a) is associated with complex, difficult-to-treat atherosclerotic lesions and fast-progressing plaques. Click here to start: Join the Cardiometabolic Health Congress in Boston in 2024.
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