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First case of stenting of a vulnerable plaque in the SECRITT I trial—the dawn of a new era?

Nature Reviews Cardiology volume 6, pages 374–378 (2009)Cite this article

Abstract

Background. A 63-year-old man presented with class II anginal symptoms.

Investigations. Cardiac catheterization, intravascular ultrasound (IVUS) virtual histology, optical coherence tomography and off-line palpography.

Diagnosis. The patient was diagnosed as having a culprit lesion in the left circumflex artery and a vulnerable plaque in the left anterior descending artery.

Management. The culprit lesion was treated with two overlapping drug-eluting stents. The vulnerable plaque was then treated with a self-expanding stent tailored to shield vulnerable plaques (vProtect® Luminal Shield). After dilatation of the stent with a low-pressure balloon, IVUS and optical coherence tomography showed excellent apposition of the stent to the vessel wall, with no signs of tissue prolapse or edge dissections. At the 6-month follow-up appointment, the stent showed complete tissue coverage without signs of in-stent restenosis.

Conclusions. Six months of follow-up has demonstrated that a patient with an IVUS-derived, thin capped fibroatheroma was successfully treated with a stent tailored to shield vulnerable plaques.

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Figure 1: Trial profile of the SECRITT I (Santorini Criteria for Investigating and Treating Thin Capped Fibroatheroma) trial.
Figure 2: Quantitative coronary angiography analysis of the intravascular-ultrasound-derived, thin-capped fibroatheroma.
Figure 3: Morphology of the patient's plaque with IVUS-derived, thin-capped fibroatheroma.
Figure 4: Palpography of the intravascular-ultrasound-derived, thin-capped fibroatheroma.

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Authors and Affiliations

  1. Department of Interventional Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands

    Steve Ramcharitar, Nieves Gonzalo, Hector M. Garcia-Garcia, Joanna J. Wykrzykowska, Jurgen M. R. Ligthart, Evelyn Regar & Patrick W. Serruys

  2. Department of Radiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands

    Robert Jan van Geuns

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  1. Steve Ramcharitar
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  2. Nieves Gonzalo
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  3. Robert Jan van Geuns
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Correspondence to Patrick W. Serruys.

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Ramcharitar, S., Gonzalo, N., van Geuns, R. et al. First case of stenting of a vulnerable plaque in the SECRITT I trial—the dawn of a new era?. Nat Rev Cardiol 6, 374–378 (2009). https://doi.org/10.1038/nrcardio.2009.34

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