Associations of coronary plaque characteristics by integrated backscatter intravascular ultrasound with detectability of vessel external elastic lamina using optical frequency domain imaging in human coronary arteries: A sub-analysis of the MISTIC-1 trial.
Aged
Anatomic Landmarks
Clinical Decision-Making
Coronary Artery Disease
/ diagnostic imaging
Coronary Vessels
/ diagnostic imaging
Female
Humans
Japan
Male
Percutaneous Coronary Intervention
/ instrumentation
Plaque, Atherosclerotic
Predictive Value of Tests
Prospective Studies
Reproducibility of Results
Scattering, Radiation
Stents
Tomography, Optical Coherence
Ultrasonography, Interventional
atherosclerotic plaque
coronary artery disease
intravascular ultrasound
optical coherence tomography
percutaneous coronary intervention
Journal
Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
ISSN: 1522-726X
Titre abrégé: Catheter Cardiovasc Interv
Pays: United States
ID NLM: 100884139
Informations de publication
Date de publication:
01 Dec 2019
01 Dec 2019
Historique:
received:
31
10
2018
accepted:
23
03
2019
pubmed:
27
4
2019
medline:
2
9
2020
entrez:
27
4
2019
Statut:
ppublish
Résumé
We sought to examine associations between plaque characteristics by intravascular ultrasound (IVUS) and detectability of external elastic lamina (EEL) by optical frequency domain imaging (OFDI) in human coronary arteries. It is often challenging to detect EEL which represents vessel size by light-based imaging modalities due to light intensity attenuation through atherosclerotic plaque. IVUS and OFDI prior to stent implantation were sequentially investigated per protocol. We identified corresponding cross-sections by minimum lumen area (MLA) or just distally to side branches as anatomical landmarks. Plaque characterization was determined by integrated backscatter IVUS analysis. We categorized detectable EEL arc by OFDI into four groups: 0≤ and <1 quadrant (group 1), 1≤ and <2 quadrants (group 2), 2≤ and <3 quadrants (group 3), or 3≤ and <4 quadrants (group 4). We prospectively studied 103 vessels in 93 patients with stable coronary artery disease. Corresponding 711 cross-sections were analyzed. Cross-sections with detectable EEL arc <2 quadrants (group 1 or 2) were observed in 86.1% of MLA sites but only in 29.3% of non-MLA sites (p < .05). Percentage plaque area (%PA) appeared to be the strongest predictor to detect EEL arc <2 quadrants with the cut-off of 60.3% (AUC 0.90; sensitivity 79.8%, specificity 85.5%). Lipid pool and calcification remained statistically significant in predicting detectable EEL arc <2 quadrants after adjustment with %PA. Presence of large plaque burden, lipid pool, and calcification significantly predicts the detectability of EEL by OFDI assessment. Locations with detectable EEL arc <2 quadrants should thus be avoided for optimal stent landing zone.
Sections du résumé
OBJECTIVES
OBJECTIVE
We sought to examine associations between plaque characteristics by intravascular ultrasound (IVUS) and detectability of external elastic lamina (EEL) by optical frequency domain imaging (OFDI) in human coronary arteries.
BACKGROUND
BACKGROUND
It is often challenging to detect EEL which represents vessel size by light-based imaging modalities due to light intensity attenuation through atherosclerotic plaque.
METHODS
METHODS
IVUS and OFDI prior to stent implantation were sequentially investigated per protocol. We identified corresponding cross-sections by minimum lumen area (MLA) or just distally to side branches as anatomical landmarks. Plaque characterization was determined by integrated backscatter IVUS analysis. We categorized detectable EEL arc by OFDI into four groups: 0≤ and <1 quadrant (group 1), 1≤ and <2 quadrants (group 2), 2≤ and <3 quadrants (group 3), or 3≤ and <4 quadrants (group 4).
RESULTS
RESULTS
We prospectively studied 103 vessels in 93 patients with stable coronary artery disease. Corresponding 711 cross-sections were analyzed. Cross-sections with detectable EEL arc <2 quadrants (group 1 or 2) were observed in 86.1% of MLA sites but only in 29.3% of non-MLA sites (p < .05). Percentage plaque area (%PA) appeared to be the strongest predictor to detect EEL arc <2 quadrants with the cut-off of 60.3% (AUC 0.90; sensitivity 79.8%, specificity 85.5%). Lipid pool and calcification remained statistically significant in predicting detectable EEL arc <2 quadrants after adjustment with %PA.
CONCLUSIONS
CONCLUSIONS
Presence of large plaque burden, lipid pool, and calcification significantly predicts the detectability of EEL by OFDI assessment. Locations with detectable EEL arc <2 quadrants should thus be avoided for optimal stent landing zone.
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
947-955Informations de copyright
© 2019 Wiley Periodicals, Inc.
Références
Mintz GS, Nissen SE, Anderson WD, et al. American College of Cardiology Clinical Expert Consensus Document on standards for acquisition, measurement and reporting of Intravascular Ultrasound Studies (IVUS). A report of the American College of Cardiology Task Force on clinical expert consensus documents. J am Coll Cardiol. 2001;37(5):1478-1492.
Maehara A, Mintz GS, Weissman NJ. Advances in intravascular imaging. Circ Cardiovasc Interv. 2009;2(5):482-490.
Garcia-Garcia HM, Costa MA, Serruys PW. Imaging of coronary atherosclerosis: intravascular ultrasound. Eur Heart J. 2010;31(20):2456-2469.
Mintz GS. Clinical utility of intravascular imaging and physiology in coronary artery disease. J Am Coll Cardiol. 2014;64(2):207-222.
Witzenbichler B, Maehara A, Weisz G, et al. Relationship between intravascular ultrasound guidance and clinical outcomes after drug-eluting stents: the assessment of dual antiplatelet therapy with drug-eluting stents (ADAPT-DES) study. Circulation. 2014;129(4):463-470.
Hong SJ, Kim BK, Shin DH, et al. Effect of intravascular ultrasound-guided vs angiography-guided Everolimus-eluting stent implantation: the IVUS-XPL randomized clinical trial. JAMA. 2015;314(20):2155-2163.
Zhang J, Gao X, Kan J, et al. Intravascular ultrasound-guided versus angiography-guided implantation of drug-eluting stent in all-comers: the ULTIMATE trial. J Am Coll Cardiol. 2018;72(24):3126-3137.
Okamura T, Onuma Y, Garcia-Garcia HM, et al. First-in-man evaluation of intravascular optical frequency domain imaging (OFDI) of Terumo: a comparison with intravascular ultrasound and quantitative coronary angiography. EuroIntervention. 2011;6(9):1037-1045.
Muramatsu T, Garcia-Garcia HM, Lee IS, Bruining N, Onuma Y, Serruys PW. Quantitative optical frequency domain imaging assessment of in-stent structures in patients with ST-segment elevation myocardial infarction: impact of imaging sampling rate. Circ J. 2012;76(12):2822-2831.
Ali ZA, Maehara A, Genereux P, et al. Optical coherence tomography compared with intravascular ultrasound and with angiography to guide coronary stent implantation (ILUMIEN III: OPTIMIZE PCI): a randomised controlled trial. Lancet. 2016;388(10060):2618-2628.
Kubo T, Shinke T, Okamura T, et al. Optical frequency domain imaging vs. intravascular ultrasound in percutaneous coronary intervention (OPINION trial): one-year angiographic and clinical results. Eur Heart J. 2017;38(42):3139-3147.
Tearney GJ, Regar E, Akasaka T, et al. Consensus standards for acquisition, measurement, and reporting of intravascular optical coherence tomography studies: a report from the International Working Group for Intravascular Optical Coherence Tomography Standardization and Validation. J Am Coll Cardiol. 2012;59(12):1058-1072.
Otake H, Kubo T, Takahashi H, et al. Optical frequency domain imaging versus intravascular ultrasound in percutaneous coronary intervention (OPINION trial): results from the OPINION imaging study. JACC Cardiovasc Imaging. 2018;11(1):111-123.
Yabushita H, Bouma BE, Houser SL, et al. Characterization of human atherosclerosis by optical coherence tomography. Circulation. 2002;106(13):1640-1645.
Kume T, Akasaka T, Kawamoto T, et al. Assessment of coronary arterial plaque by optical coherence tomography. Am J Cardiol. 2006;97(8):1172-1175.
Kawasaki M, Takatsu H, Noda T, et al. In vivo quantitative tissue characterization of human coronary arterial plaques by use of integrated backscatter intravascular ultrasound and comparison with angioscopic findings. Circulation. 2002;105(21):2487-2492.
Ohota M, Kawasaki M, Ismail TF, Hattori K, Serruys PW, Ozaki Y. A histological and clinical comparison of new and conventional integrated backscatter intravascular ultrasound (IB-IVUS). Circ J. 2012;76(7):1678-1686.
Nakayama N, Hibi K, Endo M, et al. Validity and reliability of new intravascular ultrasound analysis software for morphological measurement of coronary artery disease. Circ J. 2013;77(2):424-431.
Okamura T, Gonzalo N, Gutierrez-Chico JL, et al. Reproducibility of coronary Fourier domain optical coherence tomography: quantitative analysis of in vivo stented coronary arteries using three different software packages. EuroIntervention. 2010;6(3):371-379.
DeLong ER, DeLong DM, Clarke-Pearson DL. Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach. Biometrics. 1988;44(3):837-845.
Mintz GS, Painter JA, Pichard AD, et al. Atherosclerosis in angiographically "normal" coronary artery reference segments: an intravascular ultrasound study with clinical correlations. J Am Coll Cardiol. 1995;25(7):1479-1485.
Glagov S, Weisenberg E, Zarins CK, Stankunavicius R, Kolettis GJ. Compensatory enlargement of human atherosclerotic coronary arteries. N Engl J Med. 1987;316(22):1371-1375.
Kubo T, Yamano T, Liu Y, et al. Feasibility of optical coronary tomography in quantitative measurement of coronary arteries with lipid-rich plaque. Circ J. 2015;79(3):600-606.
Kubo T, Shinke T, Okamura T, et al. Optical frequency domain imaging vs. intravascular ultrasound in percutaneous coronary intervention (OPINION trial): one-year angiographic and clinical results. Eur Heart J. 2017;38(42):3139-3147.
Sakurai R, Ako J, Morino Y, et al. Predictors of edge stenosis following sirolimus-eluting stent deployment (a quantitative intravascular ultrasound analysis from the SIRIUS trial). Am J Cardiol. 2005;96(9):1251-1253.
Asano T, Kobayashi Y, Mintz GS, et al. Effect of plaque volume on subsequent vessel remodeling at edges of sirolimus-eluting stents. Am J Cardiol. 2006;98(8):1041-1044.
Morino Y, Tamiya S, Masuda N, et al. Intravascular ultrasound criteria for determination of optimal longitudinal positioning of sirolimus-eluting stents. Circ J. 2010;74(8):1609-1616.
Ino Y, Kubo T, Matsuo Y, et al. Optical coherence tomography predictors for edge restenosis after Everolimus-eluting stent implantation. Circ Cardiovasc Interv. 2016;9(10):e004231.