Key result
Embolic debris captured during percutaneous intervention contains oxidized phospholipids and cholesteryl esters across 100% of cases.
Observational (n=24)
This study provides direct evidence that bioactive oxidized lipids are released during percutaneous interventions, potentially mediating adverse microcirculatory outcomes such as the no-reflow phenomenon.
Objective To assess whether oxidized lipids are released downstream from obstructive plaques following percutaneous coronary and peripheral interventions using distal protection devices. Background Oxidation of lipoproteins generates multiple bioactive oxidized lipids that affect atherothrombosis and endothelial function. Direct evidence of their role during therapeutic procedures, which may result in no-reflow phenomenon, myocardial infarction and stroke, is lacking. Methods The presence of specific oxidized lipids was assessed in embolized material captured by distal protection filter devices during uncomplicated saphenous vein graft, carotid, renal, and superficial femoral artery interventions. The presence of oxidized phospholipids (OxPL) and oxidized cholesteryl esters (OxCE) was evaluated in 24 filters using liquid chromatography, tandem mass spectrometry, enzyme-linked immunosorbent assays (ELISA) and immunostaining. Results Phosphatidylcholine (PC)-containing OxPL (PC-OxPL), including PONPC [1-palmitoyl-2-(9-oxononanayl) PC], representing a major PC-OxPL molecule quantitated within plaque material, POVPC [1-palmitoyl-2-(5-oxovaleroyl)-sn-glycero-3-phosphocholine] and PGPC (1-palmitoyl-2-glutaroyl-sn -glycero-3-phosphocholine) were identified in the extracted lipid portion from all vascular beds. Several species of OxCE, such as keto, hydroperoxide, hydroxy, and epoxy cholesterol ester derivatives from cholesteryl linoleate and cholesteryl arachidonate were also present. The presence of OxPL was confirmed using enzyme linked immunoassays and immunohistochemistry of captured material. Conclusion This study documents the direct release and capture of OxPL and OxCE during percutaneous interventions from multiple arterial beds in humans. Entrance of bioactive oxidized lipids into the microcirculation may mediate adverse clinical outcomes during therapeutic procedures.
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Ravandi et al. (2014) conducted an observational in Obstructive plaques requiring percutaneous coronary and peripheral interventions (n=24). Percutaneous coronary and peripheral interventions was evaluated on Presence of specific oxidized lipids (OxPL and OxCE) in embolized material. Oxidized phospholipids and oxidized cholesteryl esters were identified in all 24 distal protection filters capturing embolized material during percutaneous interventions across multiple arterial beds.
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