Coronary artery and myocardial inflammatory reaction induced by intracoronary stent  Walter J Gomes, MD, PhD, Osvaldo Giannotti-Filho, MD, PhD, Rodrigo.

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Presentation transcript:

Coronary artery and myocardial inflammatory reaction induced by intracoronary stent  Walter J Gomes, MD, PhD, Osvaldo Giannotti-Filho, MD, PhD, Rodrigo P Paez, MD, Nelson A Hossne, MD, Roberto Catani, MD, MS, Enio Buffolo, MD, PhD  The Annals of Thoracic Surgery  Volume 76, Issue 5, Pages 1528-1532 (November 2003) DOI: 10.1016/S0003-4975(03)00872-5

Fig 1 Drawing representing the coronary artery and myocardial biopsy sites. Black arrow = stent location; white arrow = coronary artery biopsy location; white circle = myocardial biopsy location. The Annals of Thoracic Surgery 2003 76, 1528-1532DOI: (10.1016/S0003-4975(03)00872-5)

Fig 2 Photomicrograph of a coronary artery wall. Mild inflammatory reaction with coronary wall showing leukocyte infiltrate in the tunica intima and media (hematoxylin & eosin stain; magnification, ×100). The Annals of Thoracic Surgery 2003 76, 1528-1532DOI: (10.1016/S0003-4975(03)00872-5)

Fig 3 (A) Photomicrograph of a coronary artery wall. Moderate-to-intense inflammatory reaction with neutrophil infiltration in the endothelial layer (arrows). Also arterial wall thickening and edema of the tunica media (hematoxylin & eosin stain; magnification, ×40). (B) The same specimen magnified ×400, detailing the neutrophil leukocytes infiltrating the endothelium, suggestive of an acute reaction. The Annals of Thoracic Surgery 2003 76, 1528-1532DOI: (10.1016/S0003-4975(03)00872-5)

Fig 4 (A) Photomicrograph of the myocardium adjacent to the coronary artery exhibiting a significant inflammatory infiltrate and fibrosis. Also noted are edema, vascular neoformation, and congestion (hematoxylin & eosin stain; magnification, ×40). (B) Magnification ×100 of the same picture detailing the inflammatory infiltrate. The Annals of Thoracic Surgery 2003 76, 1528-1532DOI: (10.1016/S0003-4975(03)00872-5)

Fig 5 Photomicrograph of the myocardium surrounding the stent showing degeneration of the cardiac muscle and necrosis, denoting an acute process (hematoxylin & eosin stain; magnification, ×400). The Annals of Thoracic Surgery 2003 76, 1528-1532DOI: (10.1016/S0003-4975(03)00872-5)

Fig 6 (A) Photomicrograph of the myocardium adjacent to the coronary artery showing microthrombi clogging the capillaries. Also noted are myocardial fibers missing striation and nuclei, suggesting an evolving process to necrosis (hematoxylin & eosin stain; magnification, ×100). (B) Magnification ×400 of the same specimen detailing the blocked capillaries. The Annals of Thoracic Surgery 2003 76, 1528-1532DOI: (10.1016/S0003-4975(03)00872-5)