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127 arterial wall injury and temperature

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SHAPE Society

Publicada em: Saúde e medicina
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127 arterial wall injury and temperature

  1. 1. “Arterial wall injury and temperature.”
  2. 2. AULUS CORNELIUS CELSUS, 25 B.C.-50 A.D. For centuries, inflammation-derived heat is known to exist in macroscopic tissues. However, Inflammation-derived heat is only recently considered to exist at the arterial wall.
  3. 3. Active macrophages UPC’s [1(thermogenine), 2 and 3] Short-circuit in proton-pump of ATP Local heat production Arterial wall temperature elevation (one possible scenario)
  4. 4. Potential In vivo thermographic methods Non-Ivasive Invasive Non-contact ContactMagnetic Resonance Thermometry (MRT) Infrared Thermometry (IRT) Intravascular MRT Single sensor Multi sensor Catheters with flexible arms Thermographic baskets
  5. 5. 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
  6. 6. Study population/protocol Non-atherosclerotic pigs Selection 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 by Stable inflation at 12atm for 30sec. 2 thermographic scans in AOI (autom.pullback 0.3mm/sec) Injury Histology Macrophage concentration (IS: 0-4 ) 0 = Rare appearance of histolymphocytes around the stent filament 1 = sparsely located histolymphocytes around the stent filament 2 = more densely located histolymphocytes covering the stent filament 3 = diffusely located histolymphocytes, giant cells, also invading the media After 4 days 2 thermographic scans in AOI (autom.pullback 0.3mm/sec) Sacrifice, and:
  7. 7. Methods 4F over-the-wire catheter 4 independent thermistor-sensors Sensitivity 0.01o C Motorized pullback (0.1-0.5mm/sec) Specifications
  8. 8. Integration of temperature with angiography
  9. 9. -0.1 0 0.1 0.2 0.3 0.4 0.5 0 10 20 30 40 50 60 Pullback distance (mm) Temperaturedifference(oC) Sensor 1 Sensor 2 Sensor 3 Sensor 4 Before injury
  10. 10. -0.1 0 0.1 0.2 0.3 0.4 0.5 0 10 20 30 40 50 60 Distance (mm) Temperaturedifference(oC) Sensor 1 Sensor 2 Sensor 3 Sensor 4 Immediately after
  11. 11. -0.1 0 0.1 0.2 0.3 0.4 0.5 0 10 20 30 40 50 60 Distance (mm) Temperaturediff.(oC) Sensor 1 Sensor 2 Sensor 3 Sensor 4 4 days after injury
  12. 12. 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
  13. 13. 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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