Morphological analysis of atherosclerotic plaque retrieved by coronary atherectomy.
The development of atherectomy catheters and their use in clinical practice during percutaneous revascularization procedures permitted the analysis of the pathophysiology of obstructive coronary disease in vivo. The various clinical presentations of coronary disease are related to distinct morphological aspects of the culprit coronary stenosis as assessed by angiography, angioscopy or intravascular ultrasound imaging. Analysis of plaque fragments revealed the underlying histopathology. Restenotic lesions following various mechanical interventions have been studied in detail both in native coronary arteries and in bypass conduits. The biological reaction to implantation of endovascular stents involves inflammation around the stent wires as well as smooth muscle cell proliferation. Specific processes such as nitric oxide production or the activity of intramural proteases can be characterized and contribute to identify targets for future pharmacological therapy.
Division of Cardiovascular Pathology and Cardiology, University of Louvain Medical School, Brussels, Belgium.
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Depré
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Ribichini
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Wijns
D000787:Angina Pectoris / Q000473:pathology; D017546:Angioscopy; D000818:Animals; D017225:Atherectomy, Coronary; D003324:Coronary Artery Disease / Q000473:pathology*; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D007150:Immunohistochemistry; D008666:Metalloendopeptidases / Q000378:metabolism; D009131:Muscle, Smooth, Vascular / Q000473:pathology; D009203:Myocardial Infarction / Q000473:pathology; D019001:Nitric Oxide Synthase / Q000378:metabolism; D011379:Prognosis; D015607:Stents; D019714:Tissue Inhibitor of Metalloproteinases / Q000378:metabolism; D017539:Tunica Intima / Q000473:pathology; D018084:Ultrasonography, Interventional
D019714:Tissue Inhibitor of Metalloproteinases; D019001:Nitric Oxide Synthase; D008666:Metalloendopeptidases