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Abstract
Endovascular revascularization strategies have advanced tremendously over the years and are now often considered first line for treatment of peripheral arterial disease. Drug-eluting stents (DESs) have been developed as one of the tools to overcome the limitations of elastic recoil and neointimal hyperplasia observed with balloon angioplasty and bare metal stents. While these stents have been extremely successful in coronary revascularization, they have not translated as effectively to the peripheral arteries which differ in their unique mechanical environments and differences in vessel and lesion composition. DESs, through their embedded pharmaceutical agent, seek to inhibit vascular smooth muscle cell (VSMC) proliferation and migration. Paclitaxel, sirolimus, and its derivatives (-limus family) achieve VSMC inhibition through unique mechanisms. Several clinical trials have been performed to evaluate the use of DES in the femoropopliteal and infrapopliteal territory and have demonstrated overall decrease in revascularization rates and improved clinical outcomes.
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Affiliation(s)
- Chetan Velagapudi
- Department of Vascular and Interventional Radiology, Rush University Medical Center, Chicago, Illinois
| | - Sreekumar Madassery
- Department of Vascular and Interventional Radiology, Rush University Medical Center, Chicago, Illinois
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2
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Kuku KO, Singh M, Ozaki Y, Dan K, Chezar-Azerrad C, Waksman R, Garcia-Garcia HM. Near-Infrared Spectroscopy Intravascular Ultrasound Imaging: State of the Art. Front Cardiovasc Med 2020; 7:107. [PMID: 32695796 PMCID: PMC7338425 DOI: 10.3389/fcvm.2020.00107] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 05/21/2020] [Indexed: 12/13/2022] Open
Abstract
Acute coronary syndromes (ACS) secondary to coronary vessel plaques represent a major cause of cardiovascular morbidity and mortality worldwide. Advancements in imaging technology over the last 3 decades have continuously enabled the study of coronary plaques via invasive imaging methods like intravascular ultrasound (IVUS) and optical coherence tomography (OCT). The introduction of near-infrared spectroscopy (NIRS) as a modality that could detect the lipid (cholesterol) content of atherosclerotic plaques in the early nineties, opened the potential of studying “vulnerable” or rupture-prone, lipid-rich coronary plaques in ACS patients. Most recently, the ability of NIRS-IVUS to identify patients at risk of future adverse events was shown in a prospective multicenter trial, the Lipid-Rich-plaque Study. Intracoronary NIRS-IVUS imaging offers a unique method of coronary lipid-plaque characterization and could become a valuable clinical diagnostic and treatment monitoring tool.
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Affiliation(s)
- Kayode O Kuku
- MedStar Cardiovascular Research Network, MedStar Washington Hospital Center, MedStar Health Research Institute, Washington, DC, United States.,Section of Interventional Cardiology MedStar Washington Hospital Center, MedStar Heart and Vascular Institute, Washington, DC, United States.,Georgetown University Department of Medicine, Washington, DC, United States
| | - Manavotam Singh
- Section of Interventional Cardiology MedStar Washington Hospital Center, MedStar Heart and Vascular Institute, Washington, DC, United States.,Georgetown University Department of Medicine, Washington, DC, United States
| | - Yuichi Ozaki
- Section of Interventional Cardiology MedStar Washington Hospital Center, MedStar Heart and Vascular Institute, Washington, DC, United States.,Georgetown University Department of Medicine, Washington, DC, United States
| | - Kazuhiro Dan
- Section of Interventional Cardiology MedStar Washington Hospital Center, MedStar Heart and Vascular Institute, Washington, DC, United States.,Georgetown University Department of Medicine, Washington, DC, United States
| | - Chava Chezar-Azerrad
- Section of Interventional Cardiology MedStar Washington Hospital Center, MedStar Heart and Vascular Institute, Washington, DC, United States.,Georgetown University Department of Medicine, Washington, DC, United States
| | - Ron Waksman
- MedStar Cardiovascular Research Network, MedStar Washington Hospital Center, MedStar Health Research Institute, Washington, DC, United States.,Section of Interventional Cardiology MedStar Washington Hospital Center, MedStar Heart and Vascular Institute, Washington, DC, United States.,Georgetown University Department of Medicine, Washington, DC, United States
| | - Hector M Garcia-Garcia
- MedStar Cardiovascular Research Network, MedStar Washington Hospital Center, MedStar Health Research Institute, Washington, DC, United States.,Section of Interventional Cardiology MedStar Washington Hospital Center, MedStar Heart and Vascular Institute, Washington, DC, United States.,Georgetown University Department of Medicine, Washington, DC, United States
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3
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Donohue CM, Adler JV, Bolton LL. Peripheral arterial disease screening and diagnostic practice: A scoping review. Int Wound J 2019; 17:32-44. [PMID: 31680419 DOI: 10.1111/iwj.13223] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 08/18/2019] [Indexed: 11/28/2022] Open
Abstract
Early reliable, valid screening, diagnosis, and treatment improve peripheral arterial disease outcomes, yet screening and diagnostic practices vary across settings and specialties. A scoping literature review described reliability and validity of peripheral ischaemia diagnosis or screening tools. Clinical studies in the PUBMED database January 1, 1970, to August 13, 2018, were reviewed summarising ranges of reliability and validity of peripheral ischaemia diagnostic and screening tools for patients with non-neuropathic lower leg ischaemia. Peripheral ischaemia screening and diagnostic practices varied in parameters measured such as timing, frequency, setting, ordering clinicians, degree of invasiveness, costs, definitions, and cut-off points informing clinical and referral decisions. Traditional ankle/brachial systolic blood pressure index <0.9 was a reliable, valid lower leg ischaemia screening test to trigger specialist referral for detailed diagnosis. For patients with advanced peripheral ischaemia or calcified arteries, toe-brachial index, claudication, or invasive angiographic imaging techniques that can have complications were reliable, valid screening, and diagnostic tools to inform management decisions. Ankle/brachial index testing is sufficiently reliable and valid for use during routine examinations to improve timing and consistency of peripheral ischaemia screening, triggering prompt specialist referral for more reliable, accurate Doppler, or other diagnosis to inform treatment decisions.
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Affiliation(s)
- Cornelius M Donohue
- Wound Healing and Limb Preservation Center of Philadelphia LLC, Ardmore, Pennsylvania
| | - Joseph V Adler
- Department of Occupational and Physical Therapy, Good Shepherd Penn Partners at the Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Laura L Bolton
- Department of Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
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Dugandžić V, Drikermann D, Ryabchykov O, Undisz A, Vilotijević I, Lorkowski S, Bocklitz TW, Matthäus C, Weber K, Cialla-May D, Popp J. Surface enhanced Raman spectroscopy-detection of the uptake of mannose-modified nanoparticles by macrophages in vitro: A model for detection of vulnerable atherosclerotic plaques. JOURNAL OF BIOPHOTONICS 2018; 11:e201800013. [PMID: 29799670 DOI: 10.1002/jbio.201800013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 05/22/2018] [Indexed: 06/08/2023]
Abstract
Atherosclerosis is a process of thickening and stiffening of the arterial walls through the accumulation of lipids and fibrotic material, as a consequence of aging and unhealthy life style. However, not all arterial plaques lead to complications, which can lead to life-threatening events such as stroke and myocardial infarction. Diagnosis of the disease in early stages and identification of unstable atherosclerotic plaques are still challenging. It has been shown that the development of atherosclerotic plaques is an inflammatory process, where the accumulation of macrophages in the arterial walls is immanent in the early as well as late stages of the disease. We present a novel surface enhanced Raman spectroscopy (SERS)-based strategy for the detection of early stage atherosclerosis, based on the uptake of tagged gold nanoparticles by macrophages and subsequent detection by means of SERS. The results presented here provide a basis for future in vivo studies in animal models.The workflow of tracing the SERS-active nanoparticle uptake by macrophages employing confocal Raman imaging.
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Affiliation(s)
- Vera Dugandžić
- Institute of Physical Chemistry, Friedrich-Schiller University Jena, Jena, Germany
- Leibniz Institute of Photonic Technology, Jena, Germany
- Abbe Center of Photonics, Friedrich Schiller University Jena, Jena, Germany
| | - Denis Drikermann
- Institute for Organic Chemistry and Macromolecular Chemistry, Friedrich Schiller University Jena, Jena, Germany
| | - Oleg Ryabchykov
- Institute of Physical Chemistry, Friedrich-Schiller University Jena, Jena, Germany
- Leibniz Institute of Photonic Technology, Jena, Germany
- Abbe Center of Photonics, Friedrich Schiller University Jena, Jena, Germany
| | - Andreas Undisz
- Otto Schott Institute of Materials Research, Friedrich Schiller University Jena, Jena, Germany
| | - Ivan Vilotijević
- Institute for Organic Chemistry and Macromolecular Chemistry, Friedrich Schiller University Jena, Jena, Germany
| | - Stefan Lorkowski
- Abbe Center of Photonics, Friedrich Schiller University Jena, Jena, Germany
- Institute of Nutrition, Friedrich Schiller University Jena, Jena, Germany
- Competence Cluster for Nutrition and Cardiovascular Health (nutriCARD), Halle-Jena-Leipzig, Germany
- Jena Centre for Soft Matter, (JCSM), Friedrich Schiller University Jena, Jena, Germany
| | - Thomas W Bocklitz
- Institute of Physical Chemistry, Friedrich-Schiller University Jena, Jena, Germany
- Leibniz Institute of Photonic Technology, Jena, Germany
- Abbe Center of Photonics, Friedrich Schiller University Jena, Jena, Germany
| | - Christian Matthäus
- Institute of Physical Chemistry, Friedrich-Schiller University Jena, Jena, Germany
- Leibniz Institute of Photonic Technology, Jena, Germany
- Abbe Center of Photonics, Friedrich Schiller University Jena, Jena, Germany
| | - Karina Weber
- Institute of Physical Chemistry, Friedrich-Schiller University Jena, Jena, Germany
- Leibniz Institute of Photonic Technology, Jena, Germany
- Jena Centre for Soft Matter, (JCSM), Friedrich Schiller University Jena, Jena, Germany
| | - Dana Cialla-May
- Institute of Physical Chemistry, Friedrich-Schiller University Jena, Jena, Germany
- Leibniz Institute of Photonic Technology, Jena, Germany
- Abbe Center of Photonics, Friedrich Schiller University Jena, Jena, Germany
| | - Jürgen Popp
- Institute of Physical Chemistry, Friedrich-Schiller University Jena, Jena, Germany
- Leibniz Institute of Photonic Technology, Jena, Germany
- Abbe Center of Photonics, Friedrich Schiller University Jena, Jena, Germany
- Jena Centre for Soft Matter, (JCSM), Friedrich Schiller University Jena, Jena, Germany
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Kataoka Y, Puri R, Andrews J, Honda S, Nishihira K, Asaumi Y, Noguchi T, Yasuda S, Nicholls SJ. In vivovisualization of lipid coronary atheroma with intravascular near-infrared spectroscopy. Expert Rev Cardiovasc Ther 2017; 15:775-785. [DOI: 10.1080/14779072.2017.1367287] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Yu Kataoka
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Centre, Suita, Japan
| | - Rishi Puri
- Quebec Heart & Lung Institute, Laval University, Quebec City, Canada
- Cleveland Clinic Coordinating Center for Clinical Trials (C5), Cleveland Clinic, Cleveland, OH, USA
- Department of Medicine, University of Adelaide, Adelaide, SA, Australia
| | - Jordan Andrews
- Heart Health, South Australian Health & Medical Research Institute, University of Adelaide, Adelaide, Australia
| | - Satoshi Honda
- Heart Health, South Australian Health & Medical Research Institute, University of Adelaide, Adelaide, Australia
| | - Kensaku Nishihira
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Centre, Suita, Japan
| | - Yasuhide Asaumi
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Centre, Suita, Japan
| | - Teruo Noguchi
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Centre, Suita, Japan
| | - Satoshi Yasuda
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Centre, Suita, Japan
| | - Stephen J Nicholls
- Heart Health, South Australian Health & Medical Research Institute, University of Adelaide, Adelaide, Australia
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Abbas AE, Zacharias SK, Goldstein JA, Hanson ID, Safian RD. Invasive characterization of atherosclerotic plaque in patients with peripheral arterial disease using near-infrared spectroscopy intravascular ultrasound. Catheter Cardiovasc Interv 2017; 90:461-470. [PMID: 28303659 DOI: 10.1002/ccd.27023] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 01/11/2017] [Accepted: 02/15/2017] [Indexed: 11/06/2022]
Abstract
OBJECTIVES We describe the characteristics of atherosclerotic plaque in patients with peripheral arterial disease (PAD) using near-infrared spectroscopy-intravascular ultrasound (NIRS-IVUS) BACKGROUND: Imaging and autopsy studies have described atherosclerotic plaque in different vascular beds, including varying degrees of lipid, fibrosis, and calcification. Recently, NIRS has been validated as an accurate method for detecting lipid-core plaque (LCP) in the coronary circulation. Invasive evaluation of plaque composition using NIRS-IVUS has not been reported in different peripheral arterial circulations. METHODS We performed invasive angiography and NIRS-IVUS in consecutive PAD patients prior to percutaneous revascularization. Imaging evaluation included parameters from angiography, IVUS, and NIRS. NIRS-IVUS findings were compared among different vascular beds with regard to the presence and extent of calcification and LCP. RESULTS One hundred and forty-nine lesions in 126 PAD patients were enrolled, including the internal carotid (n = 10), subclavian/axillary (n = 9), renal (n = 14), iliac (n = 35), femoropopliteal (n = 69), and infrapopliteal (n = 12) arteries. Plaque morphology was calcified in 132 lesions (89%) and fibrous in 17 lesions (11%). Calcification varied from 100% of renal artery stenoses to 55% of subclavian/axillary artery stenoses. LCP was present in 48 lesions (32%) and prevalence varied from 60% in carotid artery stenoses to 0% in renal artery stenoses (P < 0.005). LCP was only observed in fibrocalcific plaque, and was longitudinally and circumferentially surrounded by a more extensive degree of calcium. CONCLUSIONS NIRS-IVUS in stable PAD patients demonstrates a high frequency of calcific plaque and statistically significant differences in the frequency of LCP in different arterial beds. LCP, when present in the peripheral circulation, is always associated with calcified plaque. The strong co-localization of calcified plaque and LCP in severe PAD lesions may provide plaque-stabilizing effects; further studies are needed. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Amr E Abbas
- Department of Cardiovascular Medicine, Center for Innovation and Research in Cardiovascular Diseases, Beaumont Health, Royal Oak, Michigan.,Oakland University William Beaumont School of Medicine, Oakland County, Michigan
| | - Sibin K Zacharias
- Department of Cardiovascular Medicine, Center for Innovation and Research in Cardiovascular Diseases, Beaumont Health, Royal Oak, Michigan.,Oakland University William Beaumont School of Medicine, Oakland County, Michigan
| | - James A Goldstein
- Department of Cardiovascular Medicine, Center for Innovation and Research in Cardiovascular Diseases, Beaumont Health, Royal Oak, Michigan.,Oakland University William Beaumont School of Medicine, Oakland County, Michigan
| | - Ivan D Hanson
- Department of Cardiovascular Medicine, Center for Innovation and Research in Cardiovascular Diseases, Beaumont Health, Royal Oak, Michigan.,Oakland University William Beaumont School of Medicine, Oakland County, Michigan
| | - Robert D Safian
- Department of Cardiovascular Medicine, Center for Innovation and Research in Cardiovascular Diseases, Beaumont Health, Royal Oak, Michigan.,Oakland University William Beaumont School of Medicine, Oakland County, Michigan
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Müller-Hülsbeck S. Eluvia™ peripheral stent system for the treatment of peripheral lesions above the knee. Expert Opin Drug Deliv 2016; 13:1639-1644. [DOI: 10.1080/17425247.2016.1230098] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Stefan Müller-Hülsbeck
- Department of Diagnostic and Interventional Radiology /Neuroradiology, Ev. Luth. Diakonissenanstalt Flensburg, Flensburg, Germany
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