Current applications of optical coherence tomography for coronary intervention.
ABSTRACT Optical coherence tomography (OCT) is the 'new kid on the block' in coronary imaging. This technology offers clinicians a high resolution (approximately 15μm), that is ten times higher than the currently accepted gold standard of intravascular ultrasound and has emerged as the ideal imaging tool for the assessment of superficial components of coronary plaques and stent struts. Novel OCT systems can perform quick and safe scanning of coronary arteries with a non-occlusive technique. A brief summary containing the key physical principles of OCT technology with particular attention to the novel Fourier domain system is presented. This review will focus on clinical and research applications of OCT in interventional cardiology. The two main fields of OCT in vivo: coronary atherosclerosis assessment and the study of vessel wall response to stent implantation in terms of strut coverage and apposition will be delineated. Limitations and future perspectives of the technique are presented.
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ABSTRACT: Some plaques lead to ST-segment elevation myocardial infarction (STEMI), whereas others cause non-ST-segment elevation acute coronary syndrome (NSTEACS). We used angiography and intravascular ultrasound (IVUS) to investigate the difference of culprit lesion morphologies in ACS. Consecutive 158 ACS patients whose culprit lesions were imaged by preintervention IVUS were enrolled (STEMI=81; NSTEACS=77). IVUS and angiographic findings of the culprit lesions, and clinical characteristics were compared between the groups. There were no significant differences in patients' characteristics except for lower rate of statin use in patients with STEMI (20% vs 44%, p=0.001). Although angiographic complex culprit morphology (Ambrose classification) and thrombus were more common in STEMI than in NSTEACS (84% vs 62%, p=0.002; 51% vs 5%, p<0.0001, respectively), SYNTAX score was lower in STEMI (8.6±5.4 vs 11.5±7.1, p=0.01). In patients with STEMI, culprit echogenicity was more hypoechoic (64% vs 40%, p=0.01), and the incidence of plaque rupture, attenuation and "microcalcification" were significantly higher (56% vs 17%, p<0.0001; 85% vs 69%, p=0.01; 77% vs 61%, p=0.04, respectively). Furthermore, the maximum area of ruptured cavity, echolucent zone and arc of microcalcification were significantly greater in STEMI compared with NSTEACS (1.80±0.99mm(2) vs 1.13±0.86mm(2), p=0.006; 1.52±0.74mm(2) vs 1.21±0.81mm(2), p=0.004; 99.9±54.6° vs 77.4±51.2°, p=0.01, respectively). Quantitative IVUS analysis showed that vessel and plaque area were significantly larger at minimum lumen area site (16.6±5.4mm(2) vs 14.2±5.5mm(2), p=0.003; 13.9±5.1mm(2) vs 11.6±5.2mm(2), p=0.003, respectively). Morphological feature (outward vessel remodeling, plaque buildup and IVUS vulnerability of culprit lesions) might relate to clinical presentation in patients with ACS.International journal of cardiology 01/2014; · 6.18 Impact Factor
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ABSTRACT: Coronary angiography has been widely used for five decades to evaluate a range of vascular pathologies and triage patients to therapeutic interventions. The inability to directly visualize the artery wall with conventional angiographic techniques has stimulated development of a number of intravascular imaging modalities. These approaches have the potential to provide a more comprehensive characterization of the burden, composition and functionality of atherosclerotic plaque, neointimal hyperplasia and allograft vasculopathy that develop within coronary arteries. The ability to use these modalities in vivo and in a serial fashion has provided a greater insight into the factors that underlie the disease process and guide therapeutic interventions.International journal of cardiology 04/2013; · 6.18 Impact Factor
- Anadolu kardiyoloji dergisi: AKD = the Anatolian journal of cardiology 12/2012; · 0.72 Impact Factor