Journal of Interventional Cardiology 

About: Journal of Interventional Cardiology is an academic journal published by Wiley-Blackwell. The journal publishes majorly in the area(s): Percutaneous coronary intervention & Myocardial infarction. It has an ISSN identifier of 0896-4327. It is also open access. Over the lifetime, 2587 publications have been published receiving 31679 citations. The journal is also known as: J Interv Cardiol.

Vulnerable plaque: the pathology of unstable coronary lesions.

Abstract: Vulnerable plaques have been defined as precursors to lesions that rupture. However, coronary thrombosis may occur from other lesions like plaque erosion and calcified nodules, although to a lesser frequency than rupture. Therefore, the definition of vulnerable plaque should be all-inclusive. Using descriptive terminology, the authors define the precursor lesion of plaque rupture as "thin-cap fibroatheroma" (TCFA). Morphologically, TCFAs have a necrotic core with an overlying thin fibrous cap ( 50 years, and in those patients with elevated levels of high sensitivity C-reactive protein. TCFAs are mostly found in the proximal left anterior descending coronary arteries and less commonly in the proximal right or the proximal left circumflex coronary arteries. In TCFAs, necrotic core length is approximately 2-17 mm (mean 8 mm) and the underlying cross-sectional luminal narrowing in over 75% of cases is < 75% (< 50% diameter stenosis). The area of the necrotic core in at least 75% of cases is < or = 3 mm2. Clinical studies of TCFAs are limited as angiography and intravascular ultrasound (IVUS) catheters cannot precisely identify these lesions. Newer catheters and other techniques are at various stages of development and will play a significant role in the understanding of plaque progression and the development of symptomatic coronary artery disease.

Drug-Eluting Bioabsorbable Magnesium Stent

Abstract: Current stent technology is based on the use of permanent implants that remain life long in the vessel wall, far beyond the time required for the prosthesis to accomplish its main goals of sealing dissection and preventing wall recoil. With the possibility to implant long vessel segments using antiproliferative drugs to prevent restenosis, the practice of transforming the coronary vessels into stiff tubes with a full metal jacket covering all side branches and being unable to adjust to the long-term wall changes, including wall remodeling with lumen ectasia becomes a serious concern. In this article, we describe the first biodegradable stent based on a magnesium alloy that allows controlled corrosion with release to the vessel wall and the blood stream of a natural body component such as magnesium with beneficial antithrombotic, antiarrhythmic, and antiproliferative properties. We also discuss the animal experiments and the initial clinical applications in 20 patients with implants below the knee, with final results soon to be released, and the plans for the first coronary study. The results of these last two studies will indicate whether the absence of a permanent implant and the antiproliferative properties shown in animals are sufficient to prevent the restenotic process in humans or whether the prosthesis must be modified by adding the biodegradable coating with conventional antiproliferative drugs.

Pathology of the thin-cap fibroatheroma: a type of vulnerable plaque.

Abstract: Thin cap atheroma is the precursor of plaque rupture, which accounts for a majority of coronary thrombi. The morphologic features of thin cap atheromas that predict rupture are unknown, but we know from studies of ruptured plaques that large necrotic cores, fibrous cap < 65 microns and numerous macrophages within the cap likely indicate instability. There is some evidence that a speckled pattern of calcification is associated with vulnerability to rupture. There are usually multiple thin cap atheroma in the hearts of patients dying with acute plaque rupture, as well as multiple fibroatheromas with intraplaque hemorrhage. Targeted therapy for the purpose of stabilizing coronary lesions that are prone to rupture is a major future goal of the interventionist.

The current use of Impella 2.5 in acute myocardial infarction complicated by cardiogenic shock: results from the USpella Registry.

Abstract: Objectives: To evaluate the periprocedural characteristics and outcomes of patients supported with Impella 2.5 prior to percutaneous coronary intervention (pre‐PCI) versus those who received it after PCI (post‐PCI) in the setting of cardiogenic shock (CS) complicating an acute myocardial infarction (AMI). Background:Early mechanicalcirculatory supportmayimproveoutcome inthesettingofCScomplicatingan AMI. However, the optimal timing to initiate hemodynamic support has not been well characterized. Methods: Data from 154 consecutive patients who underwent PCI and Impella 2.5 support from 38 US hospitals participating in the USpella Registry were included in our study. The primary end‐point was survival to discharge. Secondaryend‐pointsincludedassessmentofpatients’hemodynamicsandin‐hospitalcomplications.Amultivariate regression model was used to identify independent predictors for mortality. Results: Both groups were comparable except for diabetes (P ¼0.02), peripheral vascular disease (P ¼0.008), chronic obstructive pulmonary disease (P ¼0.05), and prior stroke (P ¼0.04), all of which were more prevalent in the pre‐PCI group. Patients inthe pre‐PCI grouphadmorelesions(P ¼0.006) andvessels(P ¼0.01)treated.These patients had also significantly better survival to discharge compared to patients in the post‐PCI group (65.1% vs.40.7%, P ¼0.003). Survival remained favorable for the pre‐PCI group after adjusting for potential confounding variables. Initiation of support prior to PCI with Impella 2.5 was an independent predictor of in‐hospital survival (Odds ratio 0.37, 95% confidence interval: 0.17–0.79, P ¼0.01) in multivariate analysis. The incidence of in‐ hospital complications included in the secondary end‐point was similar between the 2 groups. Conclusions:TheresultsofourstudysuggestthatearlyinitiationofhemodynamicsupportpriortoPCIwithImpella 2.5 is associated with more complete revascularization and improved survival in the setting of refractory CS complicating an AMI. (J Interven Cardiol 2014;27:1–11)

Short-term effects of biocorrodible iron stents in porcine coronary arteries.

Abstract: Background: Biocorrodible iron stents carry the potential to overcome limitations, such as chronic inflammation and premature recoil, posed by biodegradable polymer and magnesium alloy stents This study aimed to test the safety and efficacy of biocorrodible iron stents in porcine coronary arteries Methods: Iron stents and cobalt chromium stents were randomly deployed in the coronary arteries of juvenile domestic pigs Animals were sacrificed at 28 days, and the vessels were fixed and processed for histochemistry Results: At 28 days, iron stents started to show signs of degradation without evidence of stent particle embolization or thrombosis without traces of excess inflammation, or fibrin deposition At 28 days, the surface of the iron stent struts was black to brown and the vascular wall adjacent to the iron stent had a brownish tinge There were no statistically significant differences in any of the measured parameters between segments implanted with iron and cobalt chromium stents There were also no adverse effects in the persistent areas Conclusion: The current study demonstrates that stents made of biocorrodible iron are safe In some of the measured parameters, such as intimal thickness, intimal area, and percentage occlusion, there was a trend in favor of the iron stents