127 arterial wall injury and temperature
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Transcript of 127 arterial wall injury and temperature
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“Arterial wall injury and temperature.”
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AULUS CORNELIUS CELSUS, 25 B.C.-50 A.D.
For centuries, inflammation-derived heatis known to exist in macroscopic tissues.
However,
Inflammation-derived heat is only recentlyconsidered to exist at the arterial wall.
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Active macrophages
UPC’s[1(thermogenine), 2 and 3]
Short-circuitin proton-pump of ATP
Local heat production
Arterial wall temperature elevation(one possible scenario)
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PotentialIn vivo thermographic methods
Non-Ivasive Invasive
Non-contact ContactMagnetic Resonance Thermometry (MRT)
Infrared Thermometry (IRT)
Intravascular MRTSingle sensor
Multi sensor
Catheters with flexible arms
Thermographic
baskets
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Wall injury and Inflammation
Coronary wall injury and temperature
Purpose of the study: To explore the temperature variations (if any)of the arterial wall following coronary wall injury.
An animal study
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Study population/protocol
Non-atherosclerotic pigsSelection of a 60mm area in a normal cor.artery (AOI) 2 thermographic scans in AOI (autom.pullback 0.3mm/sec)
1.5:1 ratio balloon selection.Fwd/Rev movements of the balloon in the AOI, maintaining inflation pressure at 4 atm. (Injury), followed byStable inflation at 12atm for 30sec.2 thermographic scans in AOI (autom.pullback 0.3mm/sec)
Injury
HistologyMacrophage concentration (IS: 0-4 )0 = Rare appearance of histolymphocytes around the stent filament1 = sparsely located histolymphocytes around the stent filament2 = more densely located histolymphocytes covering the stent filament3 = diffusely located histolymphocytes, giant cells, also invading the media
After 4 days2 thermographic scans in AOI (autom.pullback 0.3mm/sec)Sacrifice, and:
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Methods
4F over-the-wire catheter4 independent thermistor-sensorsSensitivity 0.01oCMotorized pullback (0.1-0.5mm/sec)
Specifications
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Integration of temperature with angiography
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Pullback distance (mm)
Tem
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diff
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C)
Sensor 1
Sensor 2
Sensor 3
Sensor 4
Before injury
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Sensor 2Sensor 3
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Immediately after
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Sensor 2Sensor 3
Sensor 4
4 days after injury
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Macrophage concentration versus temperature
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IS
oC
temp. increment
P<0.001
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Conclusions
•PTCA balloon injury disrupts the temperature homogeneity inside a normal coronary artery.
•This temperature disruption correlates with macrophage concentration at the site of the injury.
•Since local inflammation could initiate hyperplasia and/or promote thrombosis, efforts should be made to minimize wall trauma during coronary interventions.