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Heart and Vessels

, Volume 34, Issue 3, pp 401–409 | Cite as

Plaque erosion versus rupture characterization by optical frequency domain imaging before and after coronary stenting following successful fibrinolysis for ST-segment elevation myocardial infarction

  • Vincent RouleEmail author
  • Clément Briet
  • Adrien Lemaitre
  • Pierre Ardouin
  • Mathieu Bignon
  • Rémi Sabatier
  • Katrien Blanchart
  • Farzin Beygui
Original Article
  • 64 Downloads

Abstract

Intracoronary thrombus burden affects the quality of myocardial reperfusion in the setting of ST-elevation myocardial infarction (STEMI). We aimed to study the characteristics of the plaque and thrombus assessed by intracoronary optical frequency domain imaging (OFDI) according to the presence of plaque rupture or erosion in STEMI patients treated with successful fibrinolysis. Pre-stenting thrombus and post-stenting atherothrombotic burden were compared between plaque rupture and erosion. Twenty-seven consecutive patients were included: 17 (63%) had OFDI-plaque rupture and 10 (37%) had OFDI-erosion. Thrombus volume and burden were significantly higher in case of rupture compared to erosion at baseline (13.4 ± 18.4 vs 2.8 ± 2.3 mm3; p = 0.03 and 33.8 ± 17.5 vs 17.5 ± 9.9%; p = 0.007, respectively). In the rupture group, the core of the thrombus consisted dominantly of red thrombus evenly distributed along the entire culprit plaque. In the erosion group, it consisted dominantly of white thrombus with a focal distribution near the minimal lumen area zone. After stenting, the atherothrombotic volume, burden and its distribution, as well as angiographic estimators of myocardial reperfusion were similar between groups. Our study showed that pre-PCI thrombus amount, typesetting and distribution are mainly linked to the underlying mechanism of STEMI. After stenting, the atherothrombotic burden and its distribution were similar between the groups.

Keywords

Optical frequency domain imaging ST-elevation myocardial infarction Thrombus Plaque rupture Plaque erosion 

Notes

Funding

None.

Compliance with ethical standards

Conflict of interest

The authors have no conflicts of interest to declare.

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Copyright information

© Springer Japan KK, part of Springer Nature 2018

Authors and Affiliations

  • Vincent Roule
    • 1
    • 2
    Email author
  • Clément Briet
    • 1
  • Adrien Lemaitre
    • 1
  • Pierre Ardouin
    • 1
  • Mathieu Bignon
    • 1
  • Rémi Sabatier
    • 1
  • Katrien Blanchart
    • 1
  • Farzin Beygui
    • 1
    • 2
  1. 1.Department of CardiologyCaen University HospitalCaenFrance
  2. 2.EA 4650, Normandie Université-CaenCaenFrance

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