What is the natural history of TCFA “ Thin cap fibro atheroma ” ?
(Why should the number 65 bother us in TCFA-detected by OCT? Does this number really deserve that respect? Trying to find some truths from 8 questions with & without evidence.)
1. Does TCFA really make a plaque vulnerable?
A.Yes
B. No
C. Maybe
Answer: Yes & Maybe. But there seem to be more important factors other than TCFA for a plaque to become vulnerable making TCFA not really a big deal.
2. TCFP is more common in which lesions?
A.Flow limiting lesion
B.Nonflow limiting lesion
C.No relationship between TCFA and flow
Answer: No relation, rather a random relationship.
3. What is the natural history of TCFA?
A.Get ruptured
B.Static
C.Get thickened
D.Further thinning
Answer: If someone can answer this query accurately, he can be rewarded Nobel Prize, in Lipidology
There are some studies available though.
Ref : This 2023 paper adds some anxious content to those who ignore TCFA. Long-term outcomes of patients with normal fractional flow reserve and thin-cap fibroatheroma EuroIntervention 2023;18:e1099-e1107. DOI: 10.4244/EIJ-D-22-00306
4. What to do with FFR-negative(FFR>.9), TCFA-positive lesions (tcfa<50mic)? Does stenting TCFA make it less vulnerable?
No. Stents and scaffolds were never invented to make a plaque less vulnerable.
5. How is TCFA different in stable CAD from ACS situation?
They are very different. In the ACS situation, TCFA (Whether the cap is intact or not ) needs imme...
Source: Dr.S.Venkatesan MD - Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized Source Type: blogs
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