|
|
Biomarkers, intravascular ultrasound and near-infrared spectroscopy in the assessment of vulnerable atherosclerotic plaque
Štěchovský, Cyril ; Hájek, Petr (advisor) ; Krajina, Antonín (referee) ; Kaňovský, Jan (referee)
Biomarkers, Intravascular Ultrasound and Near-Infrared Spectroscopy in the Assessment of Vulnerable Atherosclerotic Plaque Abstract The thesis describes pathophysiology of a vulnerable atherosclerotic plaque, detection of the vulnerable plaque in the stenosis of the internal carotid artery (ICA), and optimalization of carotid stenting (CAS) with near-infrared spectroscopy (NIRS) and intravascular ultrasound (IVUS) imaging. NIRS detects lipid core of the vulnerable lipid rich plaque (LRP). We demonstrated safety of NIRS-IVUS imaging during CAS. LRP was detected in one third of ICAs before CAS. Lipid signal was not correlated with plaque morphology (IVUS), biomarkers or clinical variables. CAS caused significant decrease of the lipid signal. Angiography overestimated severity of stenosis of the ICA and vastly underestimated residual stenosis after CAS. Presence of the LRP in the stenosis was neither associated with periprocedural neurological complications of CAS nor long-term adverse cardiovascular events. IVUS identified planimetric features associated with long-term restenosis or stent occlusion. After a median follow-up of 31 months, repeated NIRS-IVUS of the implanted stents showed significant expansion of the stents, diffuse neointimal hyperplasia and further reduction of the lipid signal. We assume,...
|
guest ::
