Medicine · 8 authors, 1 centre
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This retrospective cohort study used intravascular ultrasound (IVUS) to assess coronary plaques in patients with acute coronary syndromes. It found that plaques with identifiable vasa vasorum were more vulnerable and were associated with a significantly higher risk of the no-reflow phenomenon during stent placement.
The study retrospectively analyzed 166 coronary lesions in 166 patients with acute coronary syndromes using intravascular ultrasound (IVUS) and iMap-IVUS. Plaque characteristics were compared based on the presence of vasa vasorum (VV). Lesions with VV showed significantly larger necrotic core and fibrous areas, smaller densely calcified areas, larger plaque volumes, and a higher frequency of thin-cap fibroatheromas (TCFAs) at the minimum lumen area. 10.4%). Multivariate analysis identified VV presence and plaque volume as independent predictors of NRP. Limitations include the retrospective, single-center design, the inability of IVUS to definitively identify vasa vasorum or distinguish plaque from thrombus, and the lack of histopathological validation.
