127 arterial wall injury and temperature
Post on 11-Apr-2017
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“Arterial wall injury and temperature.”
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.
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)
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
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
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:
Methods
4F over-the-wire catheter4 independent thermistor-sensorsSensitivity 0.01oCMotorized pullback (0.1-0.5mm/sec)
Specifications
Integration of temperature with angiography
-0.1
0
0.1
0.2
0.3
0.4
0.5
0 10 20 30 40 50 60
Pullback distance (mm)
Tem
pera
ture
diff
eren
ce (o
C)
Sensor 1
Sensor 2
Sensor 3
Sensor 4
Before injury
-0.1
0
0.1
0.2
0.3
0.4
0.5
0 10 20 30 40 50 60
Distance (mm)
Tem
pera
ture
diff
eren
ce (o
C)
Sensor 1
Sensor 2Sensor 3
Sensor 4
Immediately after
-0.1
0
0.1
0.2
0.3
0.4
0.5
0 10 20 30 40 50 60
Distance (mm)
Tem
pera
ture
diff
. (oC
)Sensor 1
Sensor 2Sensor 3
Sensor 4
4 days after injury
Macrophage concentration versus temperature
0.00
0.10
0.20
0.30
0.40
0.50
0.60
0 1 2 3 4
IS
oC
temp. increment
P<0.001
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.
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