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Case Reports
. 2017 Jun;69(2):161-163.
doi: 10.1016/j.ehj.2016.10.002. Epub 2016 Dec 18.

Pattern of vascular remodeling of distal reference segment after recanalization of chronic total occlusion, long-term angiographic follow-up

Wassam El Din Hadad El Shafey  1
Affiliations
Case Reports

Pattern of vascular remodeling of distal reference segment after recanalization of chronic total occlusion, long-term angiographic follow-up

Wassam El Din Hadad El Shafey. Egypt Heart J. 2017 Jun.

Abstract

Chronic total occlusion (CTO) is probably caused by thrombus and lipid-rich cholesterol esters that are replaced over time by collagen and calcium deposition. Experimental models showed endothelial cell necrosis in response to vessel ligation, whereas more recent models suggest that the endothelium might retain viability guiding the subsequent development of CTO, including CTO neo-revascularization, which occurs within the lumen and in various layers of the vessel wall, by the release of paracrine substances. It is uncertain whether after CTO recanalization the recovery of anterograde reverses endothelial dysfunction, thus promoting vasodilation and positive remodeling.

Keywords: CTO; Distal reference segment; Recanalization; Vascular remodeling.

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Figures

Figure 1
Figure 1
(A) Acute remodeling pattern of distal segment of CTO proximal lesion of LAD after stenting by DES. (B) 6 months control angiography of the same segment with little gain of diameter improvement. (C) Late remodeling pattern of the same segment after 2.5 years of angiographic follow-up.
See this image and copyright information in PMC

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