For many patients, the first symptom of heart disease is acute MI, or even sudden death. Changes in lifestyle and optimal medical treatment (OMT) are vital to the prevention of serious events, but we cannot help wondering whether preventive stenting might do it. Intravascular ultrasound (IVUS), optical coherence tomography (OCT), NIRS near-infrared spectroscopy (NIRS) and computed…
TCT 2020 | Prophylactic Angioplasty for Vulnerable Plaques
Patients with vulnerable plaque identified by means of intravascular ultrasound (IVUS) and near-infrared spectroscopy (NIRS) are at a significantly increased risk of adverse cardiovascular events. Revascularization of these vulnerable lesions could prevent clinical events. That is the theory behind prophylactic angioplasty, which still needs to be proven in clinical practice. The PROSPECT ABSORB study, nested…
TCT 2020 | Using OCT to Detect Vulnerable Plaque even with Negative FFR
Optical coherence tomography (OCT) has proven useful in diabetic patients, even those with negative FFR. These findings make us rethink the ischemia and functional revascularization paradigm vs. the anatomical findings of vulnerable plaque. Diabetic patients with lesions that might be deferred base don FFR might benefit from OCT to find in these plaques certain risk…
Plaque Morphology Could Modify Functional Measurements
The vulnerable features of plaque are independently associated to functional measurements done under hyperemia far better than baseline measurements such as iFR. These findings suggest that not only stenosis severity but also plaque features contribute to functional measurements. This is a sub-study of the PACIFIC (Prospective Comparison of Cardiac PET/CT, SPECT/CT Perfusion Imaging and CT…