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Updated: Aug 23, 2026
Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
Published on: March 15, 2022
The decrease of plaque volume during percutaneous coronary intervention has a negative impact on coronary flow in
Hiroshi Sato1, Hidetaka Iida, Atsushi Tanaka
1Tsukazaki Memorial Hospital, Himeji, Japan. sato@tsukazaki.or.jp
Insights
Reduced plaque volume during percutaneous coronary intervention (PCI) negatively impacts coronary flow in acute myocardial infarction (AMI) patients. This suggests embolization during PCI may be common in AMI cases.
Area of Science:
- Cardiology
- Interventional Cardiology
- Vascular Ultrasound
Background:
- Coronary flow post-reperfusion therapy is critical for acute myocardial infarction (AMI) patient outcomes.
- The impact of plaque volume reduction during percutaneous coronary intervention (PCI) on coronary flow remains unclear.
Purpose of the Study:
- To assess the effect of decreased plaque volume after PCI on coronary flow in AMI patients.
- To investigate the relationship between plaque volume reduction and coronary flow dynamics post-PCI.
Main Methods:
- Sixty AMI patients underwent pre- and post-PCI intravascular ultrasound (IVUS) for plaque volume (PV) assessment.
- Change in plaque volume (DeltaPV) and corrected TIMI frame count (CTFC) were used to evaluate coronary flow.
- IVUS measured external elastic membrane volume, lumen volume, and plaque volume.
Main Results:
- Plaque volume decreased in all patients post-PCI.
- Inadequate reflow (CTFC >40) occurred in 21.7% of patients.
- A larger PV decrease was observed in patients with inadequate reflow (p=0.0010), and DeltaPV correlated with post-PCI CTFC (p=0.0012).
Conclusions:
- Reduced plaque volume during PCI negatively impacts coronary flow in AMI patients.
- PCI-induced embolization may be a common occurrence in AMI patients.
- Further research into managing plaque debris during PCI is warranted.
Objectives:
The aim of this study was to evaluate how decreased plaque volume during percutaneous coronary intervention (PCI) affects coronary flow in patients with acute myocardial infarction (AMI).
Background:
Coronary flow after reperfusion therapy is a major determinant of clinical outcomes in patients with AMI. However, little is still known about the changes in coronary flow that appear after PCI in response to the decreased plaque during the procedure.
Methods:
The study group comprised 60 patients with AMI who underwent pre- and post-PCI intravascular ultrasound (IVUS). Qualitative and quantitative analyses were performed on all IVUS procedures. External elastic membrane volume (EEMV), lumen volume (LV), and plaque volume (PV) were measured every 1.0 mm to include the lesion and reference segments 3.0 mm proximal and distal to the lesion. The difference between pre- and post-PCI PV was defined as the index of the decrease in plaque volume (DeltaPV). The corrected TIMI frame count (CTFC) was used to evaluate coronary flow after PCI.
Results:
Plaque volume was decreased at post-PCI IVUS in all 60 patients. Inadequate reflow (CTFC >40) was observed in 13 patients (21.7%). The decrease in PV was significantly larger in patients with inadequate reflow than in those with reflow (49.4 +/- 18.9 vs. 31.7 +/- 15.5 mm(3), p = 0.0010). Also, DeltaPV was significantly correlated with CTFC after PCI (r = 0.415, p = 0.0012).
Conclusions:
The decrease in PV during PCI has a negative impact on coronary flow after PCI in patients with AMI. Embolization induced by PCI may occur in all patients with AMI.
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