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The platelet phase, the second stage of hemostasis, commences around 15-20 seconds after an injury. It follows and overlaps with the vascular phase, during which blood vessels constrict to minimize blood loss.
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Atherosclerosis I: Introduction01:30

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Atherosclerosis is a progressive disorder characterized by the buildup of plaques on the arterial inner wall, causing them to narrow and harden over time. These plaques comprise lipids, calcium, blood components, carbohydrates, and fibrous tissue. The process primarily affects the intima of large and medium-sized arteries, reducing blood flow in any artery.Etiology and risk factorsThe cause of atherosclerosis is multifactorial, involving a complex interplay among endothelial injury, lipid...
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Coronary Artery Disease II: Pathophysiology01:26

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Coronary Artery Disease (CAD) originates from a series of events that impair the function of coronary arteries, the blood vessels responsible for delivering oxygen-rich blood to the heart muscle. The pathophysiology of CAD is closely linked to atherosclerosis, a chronic inflammatory and lipid-driven condition affecting the vascular endothelium.1. Endothelial DamageThe process begins with damage to the vascular endothelium, which serves as a protective barrier between the blood and the vessel...
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Detection of Neuritic Plaques in Alzheimer's Disease Mouse Model
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Puncturing Plaques.

Trisha Roy1,2, Garry Liu1,3, Noor Shaikh4

  • 11 Schulich Heart Program and the Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.

Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists
|September 24, 2016
PubMed
Summary
This summary is machine-generated.

Magnetic resonance imaging (MRI) effectively characterizes peripheral artery lesions, differentiating soft, hard, and calcified chronic total occlusions (CTOs). MRI findings correlate with guidewire forces needed for crossing, predicting endovascular intervention success.

Keywords:
angioplastyatherosclerosiscalcificationchronic total occlusiondisplacement forceendovascular treatment/therapyex vivo studyguidewirehistologyimagingmagnetic resonance imagingmicroCTperipheral artery diseaseplaque morphologypopliteal arterysuperficial femoral arterytibial arteryultrashort echo time sequence

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Area of Science:

  • Vascular Imaging
  • Medical Device Technology
  • Biomaterials Science

Background:

  • Peripheral artery disease (PAD) poses a significant challenge in endovascular therapy.
  • Chronic total occlusions (CTOs) represent a major hurdle in successful peripheral vascular interventions.
  • Accurate characterization of CTOs is crucial for predicting procedural success.

Purpose of the Study:

  • To validate magnetic resonance imaging (MRI) sequences for peripheral artery lesion characterization.
  • To correlate MRI characteristics of CTOs with the force required for guidewire puncture.
  • To assess MRI's potential as a surrogate for immediate endovascular therapy failure.

Main Methods:

  • Excised diseased superficial femoral, popliteal, and tibial artery segments (n=55) from amputated limbs.
  • High-resolution MRI (75 μm³ voxels) using T2-weighted (T2W) and ultrashort echo time (UTE) sequences on a 7-T scanner.
  • Classification of CTOs (n=40) into "soft," "hard," or "calcified" based on MRI signals and validation with micro-computed tomography and histology.

Main Results:

  • T2W and UTE MRI sequences accurately differentiated lesion types.
  • UTE sequences improved identification of thrombus and calcium compared to conventional MRI.
  • Guidewire puncture force significantly correlated with CTO classification: "calcified" CTOs were impenetrable, "hard" CTOs required 1.71±0.51 N, and "soft" CTOs required 0.43±0.36 N.

Conclusions:

  • MRI characteristics of PAD lesions correlate with guidewire puncture forces.
  • This correlation provides insight into CTO crossability during endovascular procedures.
  • Future research will explore the use of clinical MR scanners for predicting intervention success.