Behavior of Atherosclerotic Plaque Components After in Vitro Angioplasty and Atherectomy Studied by High Field MR Imaging |
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| Institution: | 1. Service de Physiologie et Radioisotopes, Hôpital Broussais, Paris, France;2. Cardiac Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA;3. Cardiovascular Institute, Mount Sinai Medical Center, New York, NY, USA;1. Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milano, Italy;2. 3D and Computer Simulation Laboratory, IRCCS Policlinico San Donato, San Donato Milanese, Italy;3. Department of Paediatric Cardiology and Adult Congenital Heart Disease, IRCCS Policlinico San Donato, San Donato Milanese, Italy;1. Operative Unit of Vascular Surgery, IRCCS Policlinico San Donato, San Donato Milanese, Milano, Italy;2. Laboratory of Biological Structure Mechanics, Department of Chemistry, Materials, and Chemical Engineering “Giulio Natta”, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milano, Italy;3. Department of Civil and Environmental Engineering, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milano, Italy;4. Department of Biomedical Sciences for Health, University of Milano, Milano, Italy;1. UNIDEMI, Department of Mechanical and Industrial Engineering, NOVA School of Science and Technology, Universidade NOVA de Lisboa, 2829-516 Caparica, Portugal;2. CENIMAT/I3N, Department of Materials Science, NOVA School of Science and Technology, Universidade NOVA de Lisboa, 2829-516 Caparica, Portugal;3. Helmholtz-Zentrum Geesthacht, Institute of Materials Research, Max-Planck-Str. 1, Geesthacht 21502, Germany |
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| Abstract: | Aims: Using magnetic resonance imaging (MRI), we developed in vitro models to image the response of fatty, fibrous, and calcified plaques to in vitro models of angioplasty and atherectomy, and tested the resistance of collagenous cap and lipid core to radial compression. Methods and Results: We studied the effects of balloon compression on 10 fibrous plaques with a complete collagenous cap (group A), 6 fatty plaques without cap (group B), and 5 calcified plaques (group C). Atherectomy was performed on nine other fibrous lesions (group D). In group A, fibrous cap, lipid core, and plaque did not change after radial compression despite a decrease in luminal obstruction due to medial stretching. In group B, a reduction of plaque (−30%) and lipid core (−35%) were observed. Compression dissected calcified plaques at the shoulder level. In group D, atherectomy reduced collagenous cap by 54%, and plaque by 35%. Conclusions: In these models, MRI shows 1) the high resistance of collagenous caps to radial compression, 2) a stretching effect of compression on disease-free walls, enlarging lumen in case of fibrous plaque, but a reduction and redistribution of lipid cores in case of fatty plaques, 3) the rupture of calcified arteries at the plaque shoulder, and 4) the reduction of fibrous components by atherectomy but not by angioplasty. By characterizing plaque composition, MRI may allow a predictable response of atherosclerotic arteries to interventional procedures. |
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