The Relationship Between Coronary Plaque Characteristics and Small Embolic Particles During Coronary Stent Implantation

The Relationship Between Coronary Plaque Characteristics and Small Embolic Particles During Coronary Stent Implantation Takahiro Kawamoto, Hiroyuki Okura, Yuji Koyama, Iku Toda, Haruyuki Taguchi, Koichi Tamita, Atsushi Yamamuro, Yuki Yoshimura, Yoji Neishi, Eiji Toyota, Kiyoshi Yoshida In 44 patients who underwent elective coronary stenting, lesion plaque characteristics were identified with virtual histology intravascular ultrasound, and small embolic particles during stenting were detected as high-intensity transient signals (HITS) with a Doppler guidewire. Dense calcium and necrotic core areas were significantly larger in the highest HITS count tertile, and multivariate analysis revealed only necrotic core area was an independent predictor of a high HITS count (odds ratio 4.41, p = 0.045). The HITS counts negatively correlated with coronary flow velocity reserve after stenting (r = −0.35, p = 0.017). Necrotic core component is an indicator for high risk of micro-emboli during stenting.