신두섭 (St Francis Hospital and Heart Center)

한빛사논문

조회175

St Francis Hospital and Heart Center

CV File 197 kb

JACC-Cardiovasc. Interv., May 27 2024, 17 (10) S1936-8798(24)00636-8 | https://doi.org/10.1016/j.jcin.2024.03.032 Calcified Nodule in Percutaneous Coronary Intervention: Therapeutic Challenges

Doosup Shin MD^a,∗, Keyvan Karimi Galougahi MD, PhD ^a,∗, James C. Spratt MBChB, MD ^b, Akiko Maehara MD^c,d, Carlos Collet MD, PhD ^e, Emanuele Barbato MD, PhD ^f, Flavio L. Ribichini MD ^g, Nieves Gonzalo MD, PhD ^h, Koshiro Sakai MD, PhD ^a,e, Gary S. Mintz MD^c, Gregg W. Stone MDⁱ, Evan Shlofmitz DO ^a, Richard A. Shlofmitz MD ^a, Allen Jeremias MD, MSc ^a,c, Ziad A. Ali MD, DPhil ^a,c,j

^aDepartment of Cardiology, St Francis Hospital and Heart Center, Roslyn, New York, USA

^bSt. George’s, University of London, London, United Kingdom

^cCardiovascular Research Foundation, New York, New York, USA

^dDivision of Cardiology, New York-Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York, USA

^eCardiovascular Center Aalst, OLV Clinic, Aalst, Belgium

^fDepartment of Clinical and Molecular Medicine, Sapienza University, Rome, Italy

^gDivision of Cardiology, Department of Medicine, University of Verona, Verona, Italy

^hDepartamento de Cardiología Intervencionista, Hospital Universitario Clínico San Carlos, IdISSC, Universidad Complutense, Madrid, Spain

ⁱThe Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA

^jNew York Institute of Technology, Old Westbury, New York, USA

^∗Drs Galougahi and Shin have contributed equally to this work.

Address for correspondence: Dr Ziad A. Ali

Abstract

Calcified nodules (CNs) are among the most challenging lesions to treat in contemporary percutaneous coronary intervention. CNs may be divided into 2 subtypes, eruptive and noneruptive, which have distinct histopathological and prognostic features. An eruptive CN is a biologically active lesion with a disrupted fibrous cap and possibly adherent thrombus, whereas a noneruptive CN has an intact fibrous cap and no adherent thrombus. The use of intravascular imaging may allow differentiation between the 2 subtypes, thus potentially guiding treatment strategy. Compared with noneruptive CNs, eruptive CNs are more likely to be deformable, resulting in better stent expansion, but are paradoxically associated with worse clinical outcomes, in part because of their frequent initial presentation as an acute coronary syndrome and subsequent reprotrusion of the CN into the vessel lumen through the stent struts. Pending the results of ongoing studies, a tailored therapeutic approach based on the distinct features of the different CNs may be of value.

논문정보

형식Review Paper
게재일2024년 05월 (BRIC 등록일 2024-06-03)
연구진국외 연구진
분야 의약학 > 의약학 기타

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