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Consensus document on the standard of coronary angioscopy examination and assessment from the Japanese Association of Cardiovascular Intervention and Therapeutics

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Abstract

Coronary angioscopy (CAS) is a unique diagnostic device that allows direct visualization of the vascular luminal surface in living patients. CAS contributes to elucidate the pathology of coronary artery disease. This consensus document provides a standard for CAS examination and assessment.

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References

  1. Mizuno K, Miyamoto A, Satomura K, Kurita A, Arai T, Sakurada M, Yanagida S, Nakamura H. Angioscopic coronary macromorphology in patients with acute coronary disorders. Lancet. 1991;337:809–12.

    Article  CAS  Google Scholar 

  2. Isoda K, Satomura K, Ohsuzu F. Pathological characterization of yellow and white plaques under angioscopy. Int J Angiol. 2001;10:183–7.

    Article  Google Scholar 

  3. Kubo T, Imanishi T, Takarada S, Kuroi A, Ueno S, Yamano T, Tanimoto T, Matsuo Y, Masho T, Kitabata H, Tanaka A, Nakamura N, Mizukoshi M, Tomobuchi Y, Akasaka T. Implication of plaque color classification for assessing plaque vulnerability: a coronary angioscopy and optical coherence tomography investigation. JACC Cardiovasc Interv. 2008;1:74–80.

    Article  Google Scholar 

  4. Takano M, Jang IK, Inami S, Yamamoto M, Murakami D, Okamatsu K, Seimiya K, Ohba T, Mizuno K. In vivo comparison of optical coherence tomography and angioscopy for the evaluation of coronary plaque characteristics. Am J Cardiol. 2008;101:471–6.

    Article  Google Scholar 

  5. Higo T, Ueda Y, Oyabu J, Okada K, Nishio M, Hirata A, Kashiwase K, Ogasawara N, Hirotani S, Kodama K. Atherosclerotic and thrombogenic neointima formed over sirolimus drug-eluting stent: an angioscopic study. JACC Cardiovasc Imaging. 2009;2:616–24.

    Article  Google Scholar 

  6. Ueda Y, Matsuo K, Nishimoto Y, Sugihara R, Hirata A, Nemoto T, Okada M, Murakami A, Kashiwase K, Kodama K. In-stent yellow plaque at 1 year after implantation is associated with future event of very late stent failure: the DESNOTE study (Detect the Event of Very late Stent Failure From the Drug-Eluting Stent Not Well Covered by Neointima Determined by Angioscopy). JACC Cardiovasc Interv. 2015;8:814–21.

    Article  Google Scholar 

  7. Shibuya M, Ishihara M. Coronary angioscopy for the evaluation of vessel response after drug-eluting stent implantation. Circ J. 2016;80:590–1.

    Article  Google Scholar 

  8. Shibuya M, Fujii K, Hao H, Imanaka T, Saita T, Kawakami R, Miki K, Tamaru H, Horimatsu T, Sumiyoshi A, Nishimura M, Hirota S, Masuyama T, Ishihara M. Atherosclerotic component of the yellow segment after drug-eluting stent implantation on coronary angioscopy: an ex-vivo validation study. Circ J. 2018;83:193–7.

    Article  Google Scholar 

  9. Falk E. Plaque rupture with severe pre-existing stenosis precipitating coronary thrombosis. Characteristics of coronary atherosclerotic plaques underlying fatal occlusive thrombi. Br Heart J. 1983;50:127–34.

    Article  CAS  Google Scholar 

  10. Mizuno K, Satomura K, Miyamoto A, Arakawa K, Shibuya T, Arai T, Kurita A, Nakamura H, Ambrose JA. Angioscopic evaluation of coronary-artery thrombi in acute coronary syndromes. N Engl J Med. 1992;326:287–91.

    Article  CAS  Google Scholar 

  11. Muller JE, Abela GS, Nesto RW, Tofler GH. Triggers, acute risk factors and vulnerable plaques: the lexicon of a new frontier. J Am Coll Cardiol. 1994;23:809–13.

    Article  CAS  Google Scholar 

  12. Farb A, Burke AP, Tang AL, Liang TY, Mannan P, Smialek J, Virmani R. Coronary plaque erosion without rupture into a lipid core. A frequent cause of coronary thrombosis in sudden coronary. Circulation. 1996;93:1354–63.

    Article  CAS  Google Scholar 

  13. Mizukoshi M, Imanishi T, Tanaka A, Kubo T, Liu Y, Takarada S, Kitabata H, Tanimoto T, Komukai K, Ishibashi K, Akasaka T. Clinical classification and plaque morphology determined by optical coherence tomography in unstable angina pectoris. Am J Cardiol. 2010;106:323–8.

    Article  Google Scholar 

  14. Ozaki Y, Okumura M, Ismail TF, Motoyama S, Naruse H, Hattori K, Kawai H, Sarai M, Takagi Y, Ishii J, Anno H, Virmani R, Serruys PW, Narula J. Coronary CT angiographic characteristics of culprit lesions in acute coronary syndromes not related to plaque rupture as defined by optical coherence tomography and angioscopy. Eur Heart J. 2011;32:2814–23.

    Article  Google Scholar 

  15. Mizuno K, Miyamoto A, Isojima K, Kurita A, Senoo A, Arai T, Kikuchi M, Nakamura H. A serial observation of coronary thrombi in vivo by a new percutaneous transluminal coronary angioscope. Angiology. 1992;43:91–9.

    Article  CAS  Google Scholar 

  16. Uchida Y, Masuo M, Tomaru T, Kato A, Sugimoto T. Fiberoptic observation of thrombosis and thrombolysis in isolated human coronary arteries. Am Heart J. 1986;112:691–6.

    Article  CAS  Google Scholar 

  17. Kotani J, Awata M, Nanto S, Uematsu M, Oshima F, Minamiguchi H, Mintz GS, Nagata S. Incomplete neointimal coverage of sirolimus-eluting stents: angioscopic findings. J Am Coll Cardiol. 2006;47:2108–11.

    Article  CAS  Google Scholar 

  18. Awata M, Kotani J, Uematsu M, Morozumi T, Watanabe T, Onishi T, Iida O, Sera F, Nanto S, Hori M, Nagata S. Serial angioscopic evidence of incomplete neointimal coverage after sirolimus-eluting stent implantation: comparison with bare-metal stents. Circulation. 2007;116:910–6.

    Article  CAS  Google Scholar 

  19. Awata M, Nanto S, Uematsu M, Morozumi T, Watanabe T, Onishi T, Iida O, Sera F, Minamiguchi H, Kotani J, Nagata S. Heterogeneous arterial healing in patients following paclitaxel-eluting stent implantation: comparison with sirolimus-eluting stents. JACC Cardiovasc Interv. 2009;2:453–8.

    Article  Google Scholar 

  20. Takano M, Yamamoto M, Murakami D, Inami S, Okamatsu K, Seimiya K, Ohba T, Seino Y, Mizuno K. Lack of association between large angiographic late loss and low risk of in-stent thrombus: angioscopic comparison between paclitaxel- and sirolimus-eluting stents. Circ Cardiovasc Interv. 2008;1:20–7.

    Article  Google Scholar 

  21. Takano M, Mizuno K. Angioscopic findings after drug-eluting stent implantation. Herz. 2007;32:281–6.

    Article  Google Scholar 

  22. Sotomi Y, Suzuki S, Kobayashi T, Hamanaka Y, Nakatani S, Hirata A, Takeda Y, Ueda Y, Sakata Y, Higuchi Y. Impact of the one-year angioscopic findings on long-term clinical events in 504 patients treated with first-generation or second-generation drug-eluting stents: the DESNOTE-X study. EuroIntervention. 2019;15:631–9.

    Article  Google Scholar 

  23. Mitsutake Y, Ueno T, Yokoyama S, Sasaki K, Sugi Y, Toyama Y, Koiwaya H, Ohtsuka M, Nakayoshi T, Itaya N, Chibana H, Kakuma T, Imaizumi T. Coronary endothelial dysfunction distal to stent of first-generation drug-eluting stents. JACC Cardiovasc Interv. 2012;5:966–73.

    Article  Google Scholar 

  24. Hara M, Nishino M, Taniike M, Makino N, Kato H, Egami Y, Shutta R, Yamaguchi H, Tanouchi J, Yamada Y. Difference of neointimal formational pattern and incidence of thrombus formation among 3 kinds of stents: an angioscopic study. JACC Cardiovasc Interv. 2010;3:215–20.

    Article  Google Scholar 

  25. Nishimoto Y, Ueda Y, Sugihara R, Murakami A, Ueno K, Takeda Y, Hirata A, Kashiwase K, Higuchi Y, Yasumura Y. Comparison of angioscopic findings among second-generation drug-eluting stents. J Cardiol. 2017;70:297–302.

    Article  Google Scholar 

  26. Nojima Y, Adachi H, Ihara M, Kurimoto T, Okayama K, Sakata Y, Nanto S. Impact of different coronary angioscopic findings on arterial healing one year after bioresorbable-polymer and second-generation durable-polymer drug-eluting stent implantation. J Cardiol. 2020;76:371–7.

    Article  Google Scholar 

  27. Kawakami H, Matsuoka H, Oshita A, Kono T, Shigemi S. A case of a newly developed yellow neointima at stent implanted site 1 year after sirolimus-eluting stent placement: angioscopic findings. J Cardiol. 2009;54:153–7.

    Article  Google Scholar 

  28. Nakazawa G, Otsuka F, Nakano M, Vorpahl M, Yazdani SK, Ladich E, Kolodgie FD, Finn AV, Virmani R. The pathology of neoatherosclerosis in human coronary implants bare-metal and drug-eluting stents. J Am Coll Cardiol. 2011;57:1314–22.

    Article  CAS  Google Scholar 

  29. Wan Ahmad WA, Nakayoshi T, Mahmood Zuhdi AS, Ismail MD, Zainal Abidin I, Ino Y, Kubo T, Akasaka T, Fukumoto Y, Ueno T. Different vascular healing process between bioabsorbable polymer-coated everolimus-eluting stents versus bioresorbable vascular scaffolds via optical coherence tomography and coronary angioscopy (the ENHANCE study: Endothelial Healing Assessment with Novel Coronary Technology). Heart Vessels. 2020;35:463–73.

    Article  Google Scholar 

  30. Komatsu S, Ohara T, Takahashi S, Takewa M, Minamiguchi H, Imai A, Kobayashi Y, Iwa N, Yutani C, Hirayama A, Kodama K. Early detection of vulnerable atherosclerotic plaque for risk reduction of acute aortic rupture and thromboemboli and atheroemboli using non-obstructive angioscopy. Circ J. 2015;79:742–50.

    Article  Google Scholar 

  31. Kojima K, Kimura S, Hayasaka K, Mizusawa M, Misawa T, Yamakami Y, Sagawa Y, Ohtani H, Hishikari K, Sugiyama T, Hikita H, Takahashi A. Aortic plaque distribution, and association between aortic plaque and atherosclerotic risk factors: an aortic angioscopy study. J Atheroscler Thromb. 2019;26:997–1006.

    Article  Google Scholar 

  32. Kondo H, Kiura Y, Sakamoto S, Okazaki T, Yamasaki F, Iida K, Tominaga A, Kurisu K. Comparative evaluation of angioscopy and intravascular ultrasound for assessing plaque protrusion during carotid artery stenting procedures. World Neurosurg. 2019;125:e448–55.

    Article  Google Scholar 

  33. Uchida Y, Uchida Y, Shirai S, Oshima T, Shimizu K, Tomaru T, Sakurai T, Kanai M. Angioscopic detection of pulmonary thromboemboli: with special reference to comparison with angiography, intravascular ultrasonography, and computed tomography angiography. J Interv Cardiol. 2010;23:470–8.

    Article  Google Scholar 

  34. Chibana H, Tahara N, Itaya N, Sasaki M, Sasaki M, Nakayoshi T, Ohtsuka M, Yokoyama S, Sasaki KI, Ueno T, Fukumoto Y. Optical frequency-domain imaging and pulmonary angioscopy in chronic thromboembolic pulmonary hypertension. Eur Heart J. 2016;37:1296–304.

    Article  Google Scholar 

  35. Ishihara T, Iida O, Awata M, Nanto K, Shiraki T, Okamoto S, Iida T, Fujita M, Watanabe T, Nanto S, Uematsu M. Extensive arterial repair one year after paclitaxel-coated nitinol drug-eluting stent vs bare-metal stent implantation in the superficial femoral artery. Cardiovasc Interv Ther. 2015;30:51–6.

    Article  CAS  Google Scholar 

  36. Tsukiyama Y, Shinke T, Ishihara T, Otake H, Terashita D, Kozuki A, Fukunaga M, Zen K, Horimatsu T, Fujii K, Shite J, Uematsu M, Takahara M, Iida O, Nanto S, Hirata KI. Vascular response to paclitaxel-eluting nitinol self-expanding stent in superficial femoral artery lesions: post-implantation angioscopic findings from the SHIMEJI trial (Suppression of vascular Wall Healing after Implantation of Drug Eluting Peripheral Stent in Japanese patients with the Infra inguinal lesion: serial angioscopic observation). Int J Cardiovasc Imaging. 2019;35:1777–84.

    Article  Google Scholar 

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Correspondence to Yoshiaki Mitsutake.

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Mitsutake, Y., Yano, H., Ishihara, T. et al. Consensus document on the standard of coronary angioscopy examination and assessment from the Japanese Association of Cardiovascular Intervention and Therapeutics. Cardiovasc Interv and Ther 37, 35–39 (2022). https://doi.org/10.1007/s12928-021-00770-x

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  • DOI: https://doi.org/10.1007/s12928-021-00770-x

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