title: Quantification and characterisation of released plaque material during bioresorbable vascular scaffold implantation into right coronary artery lesions by multimodality intracoronary imaging.
abstract: OBJECTIVE
  We aimed to compare intravascular ultrasound with virtual histology (VH-IVUS), optical coherence tomography (OCT) and near-infrared spectroscopy (NIRS) for their ability to quantify the true amount and characterise the nature of released plaque material during bioresorbable vascular scaffold (BVS) implantation into right coronary artery (RCA) lesions using a distal occlusion and aspiration device.
  
  
  RESULTS
  Seventeen patients underwent BVS implantation into the right coronary artery under distal protection with intracoronary imaging using VH-IVUS, OCT and NIRS. The amount of released plaque material and its lipid content (LC) were determined. Necrotic core volume and minimal fibrous cap thickness correlated with the amount of released plaque material (r=0.80 and r=-0.65, respectively) and its LC (r=0.75 and r=-0.78, respectively), but not maximal lipid core burden index (LCBI). OCT-identified thin-cap fibroatheromata (TCFA) were associated with the greatest amount of released plaque material compared to non-TCFA (46.8 [29.0;49.2] mg vs. 14.2 [11.3;19.4] mg; p=0.003) and LC (4.4 [4.0;4.8] mg vs. 2.0 [1.8;2.5] mg; p=0.000).
  
  
  CONCLUSIONS
  VH-IVUS and OCT but not NIRS parameters quantify and characterise the amount of released plaque material. TCFA is associated with the highest amount of released plaque material and may therefore benefit from the use of protection devices.
authors.affiliation: Institute for Pathophysiology, West German Heart and Vascular Center Essen, University of Essen Medical School, University Duisburg-Essen, Essen, Germany.
authors.forename: Heike A
authors.initials: HA
authors.lastname: Hildebrandt
authors.forename: Polykarpos C
authors.initials: PC
authors.lastname: Patsalis
authors.forename: Fadi
authors.initials: F
authors.lastname: Al-Rashid
authors.forename: Markus
authors.initials: M
authors.lastname: Neuhäuser
authors.forename: Tienush
authors.initials: T
authors.lastname: Rassaf
authors.forename: Gerd
authors.initials: G
authors.lastname: Heusch
authors.forename: Philipp
authors.initials: P
authors.lastname: Kahlert
authors.forename: Petra
authors.initials: P
authors.lastname: Kleinbongard
mesh_terms: D020341:Absorbable Implants / Q000009:adverse effects; D000368:Aged; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods; D009336:Necrosis; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging* / Q000473:pathology; D041623:Tomography, Optical Coherence / Q000379:methods; D018084:Ultrasonography, Interventional / Q000379:methods