Renu Virmani

..The focus of this review is to demonstrate the efficacy of the Genous stent in preclinical studies, specifically to show the effectiveness of the anti-CD34+ coating in promoting endothelialization and reducing thrombogenicity...

..The results from registries support the effectiveness of the atherectomy devices; however, prospective randomized controlled trials are needed to confirm their benefit...

..A parametric study was conducted to assess the effect of intima stiffness and plaque morphology on peak cap stress...

..This review discusses the potential role of intraplaque vasa vasorum in lesion instability as it relates to plaque rupture...

..Further studies are needed to better understand the mechanisms that govern greater inflammation and plaque burden in diabetics...

..The healing response after device implantation has not previously been characterized in humans...

..It has only recently been recognized that their identification in living patients might help reduce the incidence of sudden coronary death...

..The purpose of this study was to assess the pathological responses of atherosclerotic saphenous vein bypass grafts (SVBGs) to drug-eluting stents (DES) versus bare-metal stents (BMS)...

..Using autopsy data, we evaluated the pathological responses of the stented segment in patients treated with DES for AMI and compared with patients with stable angina...

..This study sought to examine the capability of optical frequency domain imaging (OFDI) to characterize various morphological and histological responses to stents implanted in human coronary arteries...

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..The purpose of this study was to assess the mechanism(s) of late stent thrombosis (LST) and vascular healing responses in first-generation polymeric drug-eluting stents (DES)...

..Because the time course of complete healing with DES in man is unknown, the optimal duration of antiplatelet treatment remains to be determined...

..The cause of DES LST is multifactorial with delayed healing in combination with other clinical and procedural risk factors playing a role...

..A multitargeted approach involving selective local antiangiogenic agents should contribute to prevention of plaque progression and its clinical consequences...

..e., biodegradable polymer) coronary drug-eluting stent (DES) (BioMatrix™; Biosensors International, Singapore) to three currently marketed FDA/CE- mark approved non-erodible polymer-coated DES in a porcine model...

..Human coronary bare-metal stents (BMS) and drug-eluting stents (DES) from autopsy cases with implant duration >30 days were examined for the presence of neointimal atherosclerotic disease...

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..The occurrence of late stent thrombosis in DES is also shown to be associated with greater presence of uncovered stent struts at the high shear region, which is likely due to local flow mechanics...

..1 ± 21.9 vs. BSA = 49.9 ± 21.8%, p < 0.03). Immobilization of cRGD peptides on strut surfaces represents an innovative strategy to improve endothelialization, which may facilitate vascular healing after stent implantation...

..DES was also associated with premature atherosclerotic changes versus BMS...

..The aim of this study was to perform pathologic assessment on stent fracture...

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..Although atherosclerotic models, especially in the rabbit, have existed for a long time, a comparative study of various drug-eluting stent (DES) implantations in atherosclerotic arteries have not been systematically studied...

..In this study, we hypothesized that an antihuman-CD34 antibody immobilized on the surface of commercially available sirolimus-eluting stents (SES) could enhance re-endothelialization compared with SES alone...

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..Moreover, in most cases measures of plaque area or volume are generally considered better predictors of an inflammatory process consistent with atherosclerotic disease rather than intimal medial thickness...

..The histologic features associated with symptomatic and asymptomatic carotid disease are also addressed, along with the issues surrounding current stent-based therapies for the prevention of major recurrent vascular events...

..These findings together with the association of Lp-PLA2 in apoptotic macrophages suggest a potential role in promoting plaque instability...

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..Therefore, intraplaque hemorrhage may not be a passive event, as once considered as studies continue to support the relationship of intraplaque hemorrhage and necrotic core expansion...

..Both may lead to late stent thrombosis. Other factors that increase risk are penetration of the necrotic core, bifurcation stenting and malapposition...

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..No other congenital anomalies were identified. Total anomalous origin of the coronary arteries from the pulmonary trunk or artery should be considered in cases of sudden unexpected death in infants...

..Despite widespread optimism in the success of cell-based therapy, inherent difficulties remain in the identification of effective cell populations proposed for cell-based therapy in the human heart...

..The next-generation DES will probably be safer, with goals of improving endothelialization and more rapid arterial healing compared with first- and second-generation DES...

..Patients receiving overlapping drug-eluting stents need more frequent follow-up than patients with nonoverlapping stents...

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..Various atherosclerotic risk factors have been linked to aortic stenosis and there are mechanistic similarities between atherosclerosis and CAS. The precise pathologic mechanisms underlying aortic stenosis are poorly understood...

..These cardiac myofibroblastic tumors are readily distinguished from other endocardial-based cardiac tumors, including papillary fibroelastoma and myxoma, which may present clinically in the same manner...

..This article outlines a protocol for ex vivo, postmortem cardiac examination of stented arterial segments with microcomputed tomography followed by histopathologic analysis and highlights the complementary nature of these modalities...

..Since the time course of complete healing with DES is unknown, the optimal duration of antiplatelet treatment remains to be determined...

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..Ultimately, however, the identification of important molecular surrogates in early lesion progression may eventually predict late-term risk and likely will provide the ideal strategy for reducing the morbidity and mortality of stroke...

..In short, the future for bio-erodible polymers to treat symptomatic coronary disease is bright with the promise of important and novel therapeutic potential...

..This study sought to assess agreement between an intravascular near-infrared spectroscopy (NIRS) system and histology in coronary autopsy specimens...

..Therefore, the concept of palliative treatment must be reserved for only those who have progressed beyond preventive measures...

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..NNA is less often isolated and best classified as giant cell aortitis. Adult NA has histologic features classically associated with Takayasu disease but is limited primarily to the ascending aorta and has no sex predominance...

..Other rare tumors, including histiocytoid cardiomyopathy, hemangioma, germ cell tumors, and sarcomas, may occur in children in the heart and are discussed...

..The important role played by genetics in some of these cardiovascular diseases is presented as well as toxic and drug-related etiologies...

..We undertook the first histological comparative evaluation between genetically confirmed HGPS and the CVD of aging...

..Endovascular cryotherapy designed to induce apoptosis in arterial smooth muscle cells may limit neointimal formation and thereby improve the durability of conventional angioplasty...

..We sought to demonstrate the safety and performance of the actinomycin D-coated Multilink-Tetra stent(Guidant Corp., Santa Clara, California) in the treatment of patients with single de novo native coronary lesions...

..The expression of RAGE and EN-RAGE may further compromise cell survival and promote plaque destabilization...

..These factors may increase the risk of plaque destabilization...

..The US Food and Drug Administration recently issued a warning of subacute thrombosis and hypersensitivity reactions to sirolimus-eluting stents (Cypher). The cause and incidence of these events have not been determined...

..We encourage healthcare policy makers to promote translational research for screening and treatment of vulnerable patients...

..1) and type 2 diabetes (risk ratio, 2.9). Because these risk factors are associated with SCD in blacks, they may be important targets for reducing the disparately high rate of SCD in blacks as compared with whites...

..The influence of risk factors for coronary artery disease on culprit lesion morphology is also discussed. Finally, the value of coronary calcification, as a predictor of unstable plaques in the clinical setting, is explored...

..These data suggest the use of stenting strategies that reduce inflammation and neoangiogenesis to reduce the incidence of restenosis...

..CONCLUSIONS: Specific accumulation of versican, hyaluronan, and CD44 at the sites of plaque erosion implicates an involvement of these molecules in events associated with acute coronary thrombosis...

..5 micromol/L). CONCLUSIONS: Increased serum homocysteine is associated with sudden death in the absence of acute coronary thrombosis, especially with concomitant diabetes, and with the presence of lipid-poor, fibrous plaques...

..This study presents the histological findings of atherectomy specimens from a subset of these patients receiving implants...

..Targeted therapy for the purpose of stabilizing coronary lesions that are prone to rupture is a major future goal of the interventionist...

..Impaired intimal healing (ie, the failure to form a complete neointimal layer over stent struts) extends the window during which stents are prone to thrombosis...

..Immunohistochemical staining for CD61 and fibrin II is helpful in diagnosing TTP and distinguishing it from DIC...

..Our purpose was to quantify the frequency and distribution of suspected vulnerable lesions, defined as thin-capped fibroatheroma (TCFA) and ruptured plaque, in human coronary artery autopsy specimens...

..The use of growth factors may prevent this. The aim of this study was to assess early and delayed administration of granulocyte colony-stimulating factor (G-CSF) in a porcine model of myocardial infarction (MI) and reperfusion...

..The development of this novel approach to prevent plaque progression might add to the armamentarium of preventive measures for acute myocardial infarction, stroke and sudden cardiac death...

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..Although mesenchymal stem cells (MSCs) show promising signs in reducing myocardial infarct (MI) size, the safety of endomyocardial delivery and the most efficacious dose is unknown...

..CONCLUSION: MR microscopy enabled identification of morphologic arterial wall features that enable discrimination of progressive PIT lesions from nonprogressive AIT or IXA lesions...

..Although surgical excision was possible in all patients, long-term follow-up will be required to determine the true biologic behavior of these neoplasms...

..CONCLUSIONS: Inflammation, calcification, and medial thinning are primary determinants of positive remodeling, which appears to be a feature of plaque instability...

..CONCLUSIONS: Arterial stenting causes arterial wall hypoxia followed by Ad-MV formation. The TKI SU11218 inhibits both Ad-MV formation and IH and represents a promising therapeutic agent to prevent in-stent restenosis...

..04). CONCLUSIONS: Statin use may exert pleiotropic effects on plaque phenotype. However, not the presence of macrophages but activation with subsequent protease and cytokine release may be attenuated by statin use...

..In conclusion, intramural thrombus was colored as fibrous or fibrofatty by VH IVUS, reducing VH accuracy in these kinds of lesions...

..Although the clinical predictors of LST have been reported, specific morphological and histological correlates of LST remain unknown...

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..Therefore long-term (24-30 months) angiographic and/or IVUS follow-up studies in man will be required to determine if drug-eluting stents will behave similarly to animal studies at 3 and 6 months...

..CONCLUSION: This study demonstrates the feasibility of noninvasive imaging of atherosclerosis with radiolabeled annexin A5 in transgenic mouse models of human atherosclerosis...

..The most likely candidates for the inclusions are either calcified macrophages or smooth muscle cells that have undergone apoptosis...

..Although atheroembolization can cause renal dysfunction during renal stent procedures, whether adjunctive use of embolic protection devices or glycoprotein IIb/IIIa inhibitors improves renal function is unknown...

..CONCLUSIONS: Decorin induces calcification of arterial smooth muscle cell cultures and colocalizes to mineral deposition in human atherosclerotic plaque, suggesting that decorin functions as promoter of intimal calcification...

..The NMR signal can be analyzed to obtain tissue contrast parameters such as T1, T2 and the diffusion coefficient, which may be used to detect lipid-rich vulnerable plaques in the coronary arteries...

..The high accumulation of alpha-SMA-positive MFs in erosions compared with stable plaques correlates with the higher appearance of thrombotic complications in this situation...

..The development of relevant animal models should allow further insight into the pathophysiology of coronary thrombosis in the absence of rupture...

..It is the hope that this usage might be of value to the larger community of scientists working in this field, and that widespread adoption of a common nomenclature would accelerate progress in the prevention of acute coronary events...

..Ongoing research into animal models will reconcile apparent differences with clinical trials and advance our understanding of how to apply animal models to clinical stenting in the era of DESs...

..CONCLUSIONS: Short-term infusion Ep plus low-dose rt-PA acutely neutralizes the ability of damaged endothelial surfaces to recruit new platelets by inhibiting platelet aggregation and eliminating residual mural thrombus...

..To evaluate the feasibility of noninvasive assessment of the characteristics of disrupted atherosclerotic plaques, the authors interrogated the culprit lesions in acute coronary syndromes (ACS) by multislice computed tomography (CT)...