Estimating an embolic source in peripheral artery disease using non-obstructive general angioscopy and histopathology.

Unlabelled: Spontaneously ruptured aortic plaques are known to scatter frequently. Peripheral artery disease (PAD) is assumed to be exacerbated by aortic embolism besides local atherosclerosis. However, it has been challenging to show where the embolic plug came from.

Different Characteristics and Interleukin-6 Ratios of Scattering-Type Aortic Plaques.

Background Cholesterol crystals (CCs) are related to innate inflammation in spontaneously ruptured aortic plaques (SRAPs), and variability exists in the CCs and interleukin (IL)-6 ratio in SRAPs. Methods The prevalence of scattering-type ruptures that glittered against the light of angioscopic fibers (puff-chandelier ruptures) and those that did not (puff ruptures) was analyzed in 848 patients with suspected coronary artery disease. Overall, 177 puff-chandelier ruptures and 105 puff ruptures were sampled using nonobstructive general angioscopy (NOGA).

Atherosclerosis of the aorta before blue toe syndrome: Spontaneously ruptured aortic plaques revealed by non-obstructive general angioscopy.

Unlabelled: A 50-year-old man who had undergone endovascular therapy 70 days previously was referred to us for the sudden onset of cyanosis with rest pain in the bilateral lower limbs. The patient was diagnosed with blue toe syndrome. Although computed tomography angiography showed irregular aortic wall thickness, preoperative aortic angioscopy detected a remarkable number of spontaneously ruptured aortic plaques, such as puff-chandelier ruptures, predominantly in the abdominal aorta.

Demonstrating an Adult Ventricular Septal Defect Using Non-obstructive General Angioscopy.

A ventricular septal defect (VSD) is a common congenital heart disease, and the transcatheter technique for VSD requires practical guidance because it requires a complicated procedure. A non-obstructive angioscopy catheter system via the right ventricle successfully revealed an approximately 3-mm VSD with the shape of a rugby ball at the center of the white membranous septum of Kirklin type II in an older female with suspected coronary artery disease. A white membranous terraced septum was observed to be surrounded by a reddish ventricle.

Multiple and Multidirectional Fissure Bleedings in a Patient With a Spontaneous Isolated Dissection of the Iliac Artery.

A 63-year-old man with a history of hypertension and dyslipidemia on medication was found to have an enlargement of an asymptomatic iliac artery aneurysm with an ulcer-like projection on computed tomography angiography. The longer and shorter diameter of the right iliac was increased from 24.0 × 18.

Angioscopy-Guided Selective Pulmonary Thrombectomy and Angioscopy-Monitored Systemic Thrombosis for a Pulmonary Embolism.

Few modalities have the capacity to demonstrate massive or fragmented thrombi to evaluate the effect of catheter-based or systemic thrombosis for pulmonary embolism (PE). We herein present a patient who underwent a thrombectomy for PE using a non-obstructive general angioscopy (NOGA) system. Small floating mobile thrombi were aspirated using the original method, and massive thrombi were aspirated using the NOGA system.

Cholesterol Crystals as the Main Trigger of Interleukin-6 Production through Innate Inflammatory Response in Human Spontaneously Ruptured Aortic Plaques.

Aim: This study aimed to clarify whether cholesterol crystals (CCs) are the main trigger of innate inflammation in human spontaneously ruptured aortic plaques (SRAPs).

Methods: This study included 260 SRAPs collected during nonobstructive general angioscopy (NOGA) from 126 patients with confirmed or suspected coronary artery disease. Interleukin (IL)-6 levels in SRAPs were measured.

Significant Contribution of Aortogenic Mechanism in Ischemic Stroke: Observation of Aortic Plaque Rupture by Angioscopy.

Background: Although embolic stroke accounts for most cerebral infarction, examinations to identify the embolic source have been insufficient. Nonobstructive general angioscopy (NOGA) has developed to allow the detailed observation of atheromatous changes of the aorta.

Objectives: The purpose of this study was to clarify the importance of the aortogenic mechanism in the development of ischemic stroke.

Continuous 1-Month Release of Cholesterol Crystals in a Patient With Acute Coronary Syndrome After Stenting.

Coronary stenting was performed for a 76-year-old patient with acute coronary syndrome with severe stenosis of the right coronary artery. Puff rupture including cholesterol crystals was detected on nonobstructive general angioscopy. One month after intervention, continuous release of cholesterol crystals was found despite successful percutaneous coronary intervention.

Debris collected in-situ from spontaneously ruptured atherosclerotic plaque invariably contains large cholesterol crystals and evidence of activation of innate inflammation: Insights from non-obstructive general angioscopy.

Background And Aims: Development and expansion of cholesterol crystals (CCs) within a lipid rich atherosclerotic core are believed to predispose to plaque rupture. We have used non-obstructive general angioscopy to described a range of appearances of spontaneously ruptured atherosclerotic plaques (SRAPs) in the aorta in-situ, and have confirmed that debris extruding from some SRAPs (puff-chandelier lesions) are rich in cholesterol crystals and leukocytes. The purpose of this study was to characterized the nature of the inflammatory infiltrate of this debris.

Novel Methods for Detecting Human Cholesterol Crystals from Sampled Blood.

Objective: Nonobstructive general angiography (NOGA) is a novel modality to detect and sample spontaneous ruptured aortic plaques (SRAPs). We aimed to establish novel methods to detect cholesterol crystals (CCs) in sampled SRAPs.

Methods: Blood specimens containing SRAPs were obtained from patients using NOGA.

Aortic plaque burden predicts vascular events in patients with cardiovascular disease: The EAST-NOGA study.

Background: Non-obstructive general angioscopy (NOGA) can be used to diagnose aortic atherosclerotic plaques. We examine the association between the number of aortic plaques detected by NOGA and the risk of subsequent cardiovascular events.

Methods: The Evaluation of AtheroScleroTic and rupture events by Non-Obstructive General Angioscopy (EAST-NOGA) was a prospective cohort study of patients with suspected coronary artery disease who underwent NOGA.

Embolic Stroke Caused by Aortic Ruptured Plaque and Thrombus Visualized by Angioscopy.

Aortogenic embolization is among the major mechanisms of cryptogenic stroke. Angioscopic surveillance of the aortic wall clearly visualized the existence of thrombi and spontaneously ruptured plaques, which dynamically liberated embolic materials. ().

Aortic angioscopy assisted thoracic endovascular repair for chronic type B aortic dissection.

Background: Non-obstructive general angioscopy is a powerful modality for detecting areas in the aorta with vulnerable plaque, which are difficult to visualize using conventional diagnostic tools such as computed tomography (CT). The aim of the present study was to clarify the efficacy and usefulness of aortic angioscopy in patients with chronic type B aortic dissection scheduled for thoracic endovascular repair (TEVAR).

Methods: Ten patients with chronic type B aortic dissection who underwent elective TEVAR were enrolled.

Detecting Free Cholesterol Crystals in a Patient With Spontaneous Cholesterol Embolization Syndrome.

Spontaneous cholesterol embolization is thought to be due to aortic plaque-derived shower emboli; however, flowing cholesterol crystals have not been detected. Free multilayer cholesterol crystals obtained from the femoral artery were observed using polarized light microscopy. Detection of these crystals may indicate the occurrence of spontaneous shower emboli.

Acute Myocardial Infarction Caused by Distal Embolization From a Proximal Ruptured Plaque.

Generally, in acute myocardial infarction, the plaque rupture site is around the occluded site. In this case, coronary angioscopy effectively detected a rupture at a nonstenotic lesion, and the consequent thrombotic occlusion may lead to acute myocardial infarction apart from rupture. Aspirated plaques contained atheromatous materials, cholesterol crystals, and fibrin.

Spontaneous ruptured aortic plaque and injuries: insights for aging and acute aortic syndrome from non-obstructive general angioscopy.

Recent advances in non-obstructive general angioscopy (NOGA) have enabled the detection of aortic atherosclerosis. The incidence of spontaneous ruptured aortic plaques (SRAPs) and aortic injuries was found to be high in patients diagnosed with or suspected of having coronary artery disease. These facts may result in a paradigm shift for diseases such as aging and acute aortic syndrome because the incidence of systemic embolic diseases and aortic disease are assumed be high.