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Interventional cardiology imaging: An essential guide

Tác giả: Abbas, Amr E.

Chủ đề:

Chủ đề: Medicine; Cardiology; Coronary artery disease; Interventional imaging modalities

Nhà xuất bản: Springer

Năm xuất bản: 2015

Loại tài liệu: Book

Mô tả vật lý: 251 p.

Định danh: 978-1-4471-5239-2

Ngôn ngữ: en

Đọc trực tuyến

Interventional cardiology has transitioned from angiographic subjective analysis of stenosis severity into assessment of plaque characteristics and objective assessment of stenosis severity. The evolution of novel interventional imaging modalities is progressively altering our understanding of coronary artery disease diagnosis and prognosis. This book will be an essential companion to assist interventional cardiologists in better assessing patients with Coronary Artery Disease. It will encompass and review all interventional imaging modalities and provide guidance for interventional cardiologists to use these modalities.

Cover Page
Title Page
Preface
Contents
Contributors
1: Basic Coronary Artery Anatomy and Histology
- Introduction
- Normal Coronary Anatomy
- Origin from the Sinus of Valsalva
- Myocardial Bridging
- The Coronary Arteries
  - Right Coronary Artery
  - Left Anterior Descending Artery
  - Left Main Artery
  - Left Circumflex Artery
- Dominance
- Histology
  - Tunic Intima
  - Vessel Wall
  - Tunica Media
  - Tunica Adventitia
- Segmental Anatomy
- Conclusions
- References
2: Physiology of Coronary Blood Flow
- Introduction
- Mechanical Determinants of Coronary Blood Flow
- Coronary Artery Perfusion Pressure
- Coronary Artery Resistance
- Myocardial Oxygen Demand and Supply
- Control of Coronary Flow and Autoregulation
  - Metabolic Factors
  - Endothelial Factors
  - Neurohormonal Factors
  - Tachycardia and Bradycardia Effects on Coronary Flow
- Coronary Vasospasm
- Pathophysiology of Coronary Artery Stenosis
  - Hemodynamic Significance of Coronary Stenosis
  - Coronary Flow Reserve
  - Assessing Significance of Coronary Stenosis
- Future
- References
3: Pathophysiology of Coronary Artery Disease
- Introduction
- Definitions: Angina
- Definition: Myocardial Infarction
- Atherosclerosis
- Coronary Artery Anatomy
- Theories of Atherogenesis
  - Encrustation Theory
  - Insudation Theory
  - Reaction to Injury Theory
- Atherosclerosis: Pathophysiology
  - Microscopic Description of the Development of an Atherosclerotic Lesion
  - Macroscopic Description of the Development of an Atherosclerotic Lesion
- Arterial Remodeling and Coronary Artery Disease
- Lesion Morphology/Type
  - AHA Classification (Fig. 3.5)
  - Type I
  - Type II
  - Type III: The Intermediate Lesion
  - Type IV
  - Type V
  - Type VI
- Plaque Erosion
- Plaque Rupture
- The Vulnerable Plaque
- Coronary Dissection
- Coronary Aneurysm
- Coronary Artery Restenosis
  - Restenosis
  - Stent Thrombosis
- Coronary Vasculitis
- Graft Failure
- Conclusions
- References
4: Qualitative and Quantitative Coronary Angiography
- Introduction
- Selective Coronary Angiography
  - Routes of Access
- Equipment Selection
  - Judkins Catheters
  - Engagement of Right Coronary Artery Using Judkins Right Catheter (Femoral Approach)
  - Engagement of the Left Coronary Artery Using Judkins Left (JL) Catheter (Femoral Approach)
  - Engagement of the Left Coronary Artery Using Amplatz (Femoral)
  - Engagement of the Right Coronary Artery Using Amplatz (Femoral)
  - Multipurpose Catheter
  - Radial Catheters
  - Special Considerations
- Cineangiographic Imaging, Radiation Dose Measurement, and Contrast Types
  - Cineangiographic Imaging
  - Contrast Types
  - Radiation Dose Measurement
- Angiographic Projections, Recommended Views for Specific Coronary Segments
  - Angiographic Projections
  - Specific Coronary Segments
  - Recommended Views for Specific Coronary Segments
    - Left Coronary Artery
    - Left Main
    - Circumflex and Marginal Branches
    - LAD and Diagonal Branches
    - LAD-Circumflex Bifurcation, Circumflex, Marginal
    - Left Anterior Descending (LAD)-Circumflex Bifurcation
    - Bypass Graft Angiography
    - Right Coronary Artery
    - Left Coronary Artery Bypass Graft Angiography
    - Right Coronary Bypass Graft Angiography
    - Left Internal Mammary Artery Graft Catheterization
    - Right Internal Mammary Artery Graft Catheterization
- Ventriculography
  - Wall Motion Abnormalities
  - Calculation of LV Ejection Fraction
  - Mitral Regurgitation
  - Ventricular Septal Defect
- Identifying Specific Coronary and Aortic Abnormalities
  - Coronary Artery Aneurysms (CAA)
  - Coronary Thrombus
  - Calcified Aortic Valve
  - Calcified Coronary Artery Plaque
  - Coronary Artery Dissection
  - Coronary Artery Tortuosity
- Procedural Complications
  - Local Complications
    - Hematoma
    - Pseudoaneurysm
    - Retroperitoneal Hematoma
    - Arteriovenous (AV) Fistula
  - Contrast Induced Nephropathy (CIN)
  - Coronary Complications
    - Coronary Artery Dissection
    - Coronary Artery Spasm
    - Coronary Artery Perforation
  - Additional Complications: Death, Stroke, Arrhythmias, and Heart Failure
    - Death
    - Arrhythmias
    - Heart Failure
    - Stroke
- Angiographic Evaluation of Coronary Perfusion
- Quantitative Coronary Angiography (QCA)
- Assessment of Lesions Characteristics and Suitability for PCI
- Conclusions
- Limitations of Coronary Angiography
- References
5: Imaging of Coronary Artery Anomalies
- Introduction
- Normal Coronary Anatomy
- Embryology of Coronary Artery Development
- Incidence
- Classification of Anomalies
  - Anomalous Coronary Artery from the Opposite Sinus (ACAOS)
  - Anomalous Coronary Artery from the Pulmonary Artery, the Bland-White-Garland Syndrome
  - Coronary Fistulas
  - Myocardial Bridging
- Symptoms
- Pathophysiology
- Imaging for Coronary Anomalies
  - Echocardiography
  - Coronary CT Angiography (CTA)
  - Coronary Magnetic Resonance Angiography
  - Invasive Coronary Angiography
- Screening for Coronary Anomalies
- Management of Coronary Anomalies
- Conclusions
- References
6: Coronary Flow Resistance and Reserve
- Background and Physiology
  - Relationship of Coronary Artery Resistance and Basal Coronary Blood Flow
  - Hyperemic Coronary Blood Flow
- Measures of Resistance and Flow in the Cardiac Catheterization Laboratory
- Assessing Coronary Indices of Flow and Resistance: Technique and Performance
- Coronary Flow Reserve in Different Populations
  - Hypertension
  - Cardiac Transplant
  - Diabetes Mellitus
  - Dyslipidemia
  - FFR Versus CFR
  - Stenosis
  - Tobacco Exposure
- Measurements Obtained
  - Average Peak Velocity
  - Distal CFR
  - Relative CFR
- Pitfalls and Challenges
- References
7: Fractional Flow Reserve
- Background and Physiology
- Introduction
- Characteristics of Fractional Flow Reserve
  - Abnormal FFR Has a Well-defined Cutoff with a Narrow Grey Zone of 0.75–0.8
  - FFR Is Not Influenced by Systemic Hemodynamics
  - The Theoretical Normal FFR Value Is 1 Regardless of the Patient, the Vessel, and the Myocardial Bed
  - FFR Has Unparalleled Special Resolution
  - FFR Normalizes the Stenosis Severity to Myocardial Mass Being Perfused
  - FFRmyo Accounts for Both Antegrade and Retrograde (Collateral) Blood Flow
- Artifacts, Pitfalls and Troubleshooting
  - Hyperemic Agents and Pharmacological Considerations
  - Hemodynamic Artifacts and Technical Considerations
  - Less Common Physiological FFR Artifacts
    - Hydrostatic Pressure Effect
    - Oscillation of the FFR Waveform
    - Pressure Recovery
    - Severe Hypotension, Low Flow/Low Gradient Severe Stenosis, and Paradoxical Vasoconstrictive Response
- Technique and Performance
- Specific Lesion and Patient Subsets
  - Evaluation of Indeterminate Coronary Stenosis and Multivessel CAD
    - Safety and Efficacy Data
    - Combined Anatomic and Physiologic Lesion Assessment
    - Cost Effectiveness
  - Serial Stenoses
  - Bifurcation Lesions
  - Left Main Coronary Artery
  - Acute Coronary Syndromes
  - Bypass Grafts
  - FFR Post Intervention
  - Ostial Lesions
- False Positive FFR and False Negative FFR
- Future Directions
- Conclusions
- References
8: Intravascular Ultrasound
- Background
- Introduction
- Technique and Instrumentation
- Artifacts and Pitfalls
  - Calcium
  - Non-uniform Rotational Distortion (NURD)
  - Wire Artifact
- Motion
  - Blood Speckle
  - Ringdown
- Patient Populations
  - Assessment of Intermediate Non-left Main Coronary Lesions
  - Assessment of Left Main Stenosis
  - IVUS Guided Bare Metal Stent Placement
  - IVUS Guided Drug Eluting Stent Placement
  - IVUS Guided PCI in Unprotected LM Lesions
  - IVUS Guided PCI in Bifurcation Lesions
  - Radiofrequency IVUS
- Future Directions
- References
9: Optical Coherence Tomography
- Introduction
- Optical Coherence Technology
- Image Display Techniques
  - Color Mapping
  - Intensity Scaling
  - L-mode Display
  - Co-registration of Three-dimensional OCT and Cineangiography
  - Three-dimensional Visualization
- Image Acquisition Protocols Using the FD OCT Catheter
- Lesion and Stent Morphology by OCT
- OCT Coronary Evaluation Prior to Percutaneous Coronary Intervention
- Coronary Evaluation After Percutaneous Coronary Intervention
  - Dissections
  - Malapposition
  - Plaque Protrusion
  - Stent Thrombosis
  - Strut Coverage, Restenosis, and Neoatherosclerosis
- OCT for Vessel Sizing and Determination of Ischemia
- OCT Versus IVUS Assessment of Coronary Artery Disease and Percutaneous Coronary Intervention Results
  - Artifacts
- Future Technology
- Limitations
- References
10: Intracoronary Imaging for Plaque Characterization
- Introduction
- Plaque Characterization by IVUS
  - Attenuated Plaque by IVUS
  - Calcified Plaque by IVUS
  - Plaque Burden by IVUS
  - Plaque Characterization by VH-IVUS
- Plaque Characterization by OCT
  - Calcification and Fibrous Plaque by OCT
  - Lipid-Rich Plaque and OCT-Derived Thin Cap Fibroatheroma
  - Plaque Morphology by OCT
- Plaque Characterization by NIRS
  - NIRS Detects Lipid-Core Plaque
  - NIRS and Peri-procedural Myocardial Infarction
  - NIRS Findings at Culprit Sites in ACS
  - Quantifying Lipid-Core Plaque by NIRS
- Conclusions
- References
11: Intracoronary Imaging for PCI Planning and Stent Optimization
- Intracoronary Imaging for PCI Planning
  - Assessing Lesions of Intermediate Stenosis Severity
    - Clinical Application of IVUS MLA in Non-left Main Locations
    - Measuring Target Lesion MLA
    - Clinical Application of IVUS MLA in the Left Main
    - Clinical Application of OCT MLA
  - Intracoronary Imaging for Stent Selection
  - Intracoronary Imaging to Assess the Risk of Peri-Procedural Myocardial Infarction and Angiographic No-Reflow
    - IVUS Predictors of Acute PCI-Related Complications
    - Periprocedural Infarction and No-Reflow
    - NIRS Predictors of Acute PCI-Related Complications
    - OCT Predictors of Acute PCI-Related Complications
    - Limitation of Using Intracoronary Imaging to Assess PCI Risk
- Introduction
- Intracoronary Imaging for Stent Optimization
  - Stent Optimization with IVUS or OCT
  - Stent Strut Malapposition and Underexpansion
  - Stent Edge Dissections
  - Tissue Protrusion
- Clinical Benefit Associated with Intracoronary Imaging
  - Benefit of IVUS-Guided Bare-Metal Stent Placement
  - Benefit of IVUS-Guided Drug-Eluting Stent Placement
- Conclusion
- References
12: Non-invasive Correlation of Invasive Imaging
- Background
- The Ideal Coronary Plaque Characterization Tool
- Case 1. Stress Testing: Validity and Correlation
  - Case Presentation
  - Future Use
- Case 2. Coronary Computed Tomographic Angiography: Accuracy of Disease Detection
  - Case Presentation
- Case 3. Unstable Coronary Plaque Detection by CTA
  - Case Presentation
- Case 4. CTA: Correlation to Advanced Coronary Imaging
  - Case Presentation
- Conclusion
- References
13: Intra-cardiac Echocardiography- Guided Interventional Imaging
- Introduction
  - Types of ICE
    - AcuNav/Viewflex Fixed or Phased Array Echo Catheter
    - Ultra ICE Mechanical Echo Catheter
- Phased-Array Catheter
- Main Views for ICE
  - Home View
  - Long Axis View (Also Caval View)
  - Septal View (Also Called Atrial View)
  - Short Axis View
- Examples Using Intracardiac Echocardiography
  - Secundum Atrial Septal Defect Closure
  - Patent Foramen Ovale Closure
  - Percutaneous Balloon Mitral Valvuloplasty
  - Lead Thrombus
- ICE Guidance for Intracardiac Interventions
  - ASD Evaluation
- Figure-of-Eight Stitch
- Advantages/Limitations
- Mechanical Versus Phase Array Imaging and 3D Imaging
- References
Index