Optical coherence tomography versus intravascular ultrasound for culprit lesion assessment in patients with acute myocardial infarction.
acute myocardial infarction
culprit lesion
intravascular ultrasound
optical coherence tomography
percutaneous coronary intervention
thin-cap fibroatheroma
Journal
Postepy w kardiologii interwencyjnej = Advances in interventional cardiology
ISSN: 1734-9338
Titre abrégé: Postepy Kardiol Interwencyjnej
Pays: Poland
ID NLM: 101272671
Informations de publication
Date de publication:
Jun 2020
Jun 2020
Historique:
received:
08
12
2019
accepted:
27
04
2020
entrez:
9
7
2020
pubmed:
9
7
2020
medline:
9
7
2020
Statut:
ppublish
Résumé
In patients with acute myocardial infarction (AMI) undergoing primary percutaneous coronary intervention (PCI) the implanted stent may not fully cover the whole intravascular ultrasound (IVUS)-derived thin-cap fibroatheroma (TCFA) related to the culprit lesion (CL). Whether this phenomenon is more pronounced when optical coherence tomography (OCT) assessment of the CL is performed is not known. Thus, we aimed to assess CLs in 40 patients with AMI treated with PCI, using VH (virtual histology)-IVUS and OCT before and after intervention. The results were blinded to the operator and PCI was done under angiography guidance. Uncovered lipid-rich plaques were identified in the stent reference segments of 23 (57.5%) patients: in 13 (32.5%) of them in the distal reference segment and in 19 (47.5%) of them in the proximal reference segment. In 9 of them (22.5%) lipid plaques were found in both reference segments. In 36 (90%) patients OCT confirmed lipid plaques identified as VH-derived TCFA by VH-IVUS in the reference segments of the stented segment. However, OCT confirmed that only in 2 (5%) patients were uncovered lipid plaques true TCFA as defined by histology. Comparing IVUS and OCT qualitative characteristics of the stented segments OCT detected more thrombus protrusions and proximal and distal stent edge dissections compared to IVUS (92.5 vs. 55%, Due to its superior resolution, OCT identifies TCFA more precisely. OCT more often shows remaining problems related to stent implantation than IVUS after angiographically guided PCI.
Identifiants
pubmed: 32636898
doi: 10.5114/aic.2020.96057
pii: 40857
pmc: PMC7333203
doi:
Types de publication
Journal Article
Langues
eng
Pagination
145-152Informations de copyright
Copyright: © 2020 Termedia Sp. z o. o.
Déclaration de conflit d'intérêts
The authors declare no conflict of interest.
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