Souteyrand Géraud, Arbustini Eloisa, Motreff Pascal, Gatto Laura, Di Vito Luca, Marco Valeria, Amabile Nicolas, Chisari Alberto, Kodama Takhaide, Romagnoli Enrico, Tavazzi Luigi, Crea Filippo, Narula Jagat, Prati Francesco
Department of Cardiology, Clermont-Ferrand University Hospital, Clermont-Ferrand, France.
EuroIntervention. 2015 Jul;11(3):319-24. doi: 10.4244/EIJV11I3A59.
The aim of this study was to understand better the mechanisms of repair of plaque complications causing acute coronary syndrome.
We used OCT in the acute phase and at follow-up (one to seven months) to investigate the plaque healing in 10 culprit plaques: five ruptured fibrous cap (RFC) and five intact fibrous cap (IFC) which were not treated with stent deployment and caused ST-segment elevation myocardial infarction (n=8) and non-STEMI (n=2). At follow-up OCT, the margins of the evacuated cavity in RFC plaques showed a smooth surface and a morphology similar to that of baseline images, while IFC plaques showed a smoothened intimal border and a double layering indicating organising thrombus incorporated in the superficial layers of the plaque.
In the months following a successfully dissolved acute thrombosis, OCT revealed that the cavity of RFC plaques persists and is bordered by a smooth "neointima", while IFC plaques showed features suggesting partial incorporation of the deepest layers of thrombus in the plaque.
本研究旨在更好地了解导致急性冠状动脉综合征的斑块并发症的修复机制。
我们在急性期及随访期（1至7个月）使用光学相干断层扫描（OCT）来研究10个罪犯斑块的愈合情况：5个纤维帽破裂（RFC）斑块和5个纤维帽完整（IFC）斑块，这些斑块未进行支架置入治疗，导致ST段抬高型心肌梗死（n = 8）和非ST段抬高型心肌梗死（n = 2）。在随访期OCT检查中，RFC斑块中排空腔的边缘呈现光滑表面，形态与基线图像相似，而IFC斑块显示内膜边界平滑且有双层结构，表明组织化血栓融入斑块表层。
在成功溶解急性血栓后的数月内，OCT显示RFC斑块的腔持续存在，边界为光滑的“新生内膜”，而IFC斑块表现出提示血栓最深层部分融入斑块的特征。
