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Burlington, MA, United States

Madder R.D.,Meijer | Wohns D.H.,Meijer | Muller J.E.,InfraReDx
Journal of Invasive Cardiology | Year: 2014

With an estimated 300,000 cases occurring per year in the United States alone, sudden cardiac death remains a major public health problem and in many cases is the first manifestation of coronary artery disease. Autopsy studies have established that the causative event in many cases of sudden death is rupture of an intracoronary lipid core plaque with subsequent thrombus formation. Until recently, identification of lipid core plaque in vivo has not been possible; however, a combined near-infrared spectroscopy (NIRS) and intravascular ultrasound (IVUS) catheter has become available that can detect lipid core plaque in patients undergoing coronary angiography. In this report, we present findings in 5 patients who experienced a documented sudden cardiac arrest, were successfully resuscitated, and then were studied with intracoronary NIRS-IVUS to assess the extent and location of lipid core plaque. Although the detection of lipid core plaque at the culprit site in victims of sudden death is not novel, the novelty of the present report is that NIRS permitted identification of the large lipid core plaque underlying sudden cardiac arrest in vivo, a finding in striking accord with prior autopsy observations implicating ruptured lipid core plaque in the pathogenesis of sudden cardiac death. © 2014 HMP Communications.


Erlinge D.,Lund University | Harnek J.,Lund University | Goncalves I.,Lund University | Gotberg M.,Lund University | And 2 more authors.
European Heart Journal Cardiovascular Imaging | Year: 2015

Aims Intracoronary near-infrared spectroscopy (NIRS) in ST-segment elevation myocardial infarction (STEMI) has demonstrated substantial lipid in STEMI culprit plaques. Thrombus aspiration during primary PCI reduces distal embolization and improves reperfusion. This study was performed to examine if aspiration thrombectomy reduces the lipid content of acute coronary syndrome (ACS) culprit plaques. Methods and results NIRS-IVUS imaging was performed in patients with an ACS at two hospitals in the US and Sweden. After establishment of TIMI 3 flow with an undersized balloon, NIRS was performed, followed by aspiration thrombectomy, followed by repeated NIRS. The same culprit segment was identified on the post-aspiration chemogram. The culprit lipid content was quantified before and after thrombectomy as the lipid core burden index (LCBI). A spirates were examined by histological staining for lipids, calcium, and macrophages. In 18 ACS patients (age 65±11,61%male), culprit lesions were characterized by high lipid content prior to aspiration thrombectomy. Thrombectomy resulted in a 28% reduction in culprit lesion lipid content (pre-aspiration LCBI 466±141 vs. post-aspiration 335±117, P = 0.0001). In addition to thrombus, histological analysis of aspirates demonstrated the presence of lipids, calcium, and macrophages, indicating that fragments of atherosclerotic plaques had been aspirated. Conclusion Thrombectomy aspirates both thrombus and lipid-rich fragments of the culprit atherosclerotic plaques, thereby reducing material that may embolize during stenting. Reduction of lipid content before stenting might contribute to the beneficial effects of thrombectomy and may be particularly useful if a large lipid core is present at the culprit site. © The Author 2014.


Patent
InfraReDx | Date: 2010-03-16

An apparatus for detecting vulnerable plaque within a lumen defined by an intraluminal wall is described. The apparatus includes a probe having a distal portion and a proximal portion. The apparatus includes an optical waveguide extending along the probe. The optical waveguide is configured to carry optical radiation between the distal and proximal portions, and has a distal end in communication with the intraluminal wall. The apparatus includes an interferometer coupled to the optical waveguide and configured to provide an interference signal for sub-surface imaging of the intraluminal wall, and a processing module configured to provide spectroscopic information from detected intensity of light collected from the intraluminal wall.


Disclosed is a high resolution intravascular ultrasound imaging system including a catheter with a rotatable imaging assembly and an image processor. The image processor in turn features a pulser configured to energize the ultrasound transducer of the rotatable imaging assembly with a multi-frequency ultrasound waveform signal. The image processor further contains a receiver configured to decompose received ultrasound energy as reflected by the target vessel into a plurality of individual subband signals, individually process these signals and reconstitute these signals into a high resolution image of the blood vessel. The IVUS system of the invention may be useful in characterizing cap thickness of vulnerable plaques or other detailed studies of blood vessels.


Patent
InfraReDx | Date: 2010-11-02

An apparatus for detecting vulnerable plaque within a lumen defined by an intraluminal wall is described. The apparatus includes a probe having a distal portion and a proximal portion. The apparatus includes an optical waveguide extending along the probe. The optical waveguide is configured to carry optical radiation between the distal and proximal portions, and has a distal end in communication with the intraluminal wall. The apparatus includes an interferometer coupled to the optical waveguide and configured to provide an interference signal for sub-surface imaging of the intraluminal wall, and a processing module configured to provide spectroscopic information from detected intensity of light collected from the intraluminal wall.

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