Morphometric Assessment of Coronary Stenosis Relevance With Optical Coherence Tomography

Gonzalo, Nieves; Escaned, Javier; Alfonso, Fernándo; Nolte, Christian; Rodriguez, Vera; Jimenez-Quevedo, Pilar; Bañuelos, Camino; Fernández‐Ortíz, Antonio; Garcı́a, Eulogio; Hernández‐Antolín, Rosana; Macaya, Carlos

doi:10.1016/j.jacc.2011.09.078

Cited by 188 publications

(100 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…8 Previous reports using IVUS-derived MLA to assess myocardial ischemia are summarized in Table 3. 7-13,26, 27 The accuracy of IVUS-derived MLA to identify functional ischemia ranged from 66% to 79%. Thus, IVUS-derived MLA is limited in accuracy.…”

Section: Discussionmentioning

confidence: 99%

Intravascular Ultrasound-Derived Virtual Fractional Flow Reserve for the Assessment of Myocardial Ischemia

Seike

Uetani

Nishimura

et al. 2018

Circ J

View full text Add to dashboard Cite

Background: Fractional flow reserve (FFR) is widely used for the assessment of myocardial ischemia. Intravascular ultrasound (IVUS) is an intracoronary imaging method that provides information about lumen and vessel morphology. Previous studies on the expanded use of IVUS to identify functional ischemia have noted an association between anatomy and physiology, but IVUS-derived minimum lumen area (MLA) has a weak-moderate correlation with myocardial ischemia compared with FFR. We developed a method to calculate FFR using IVUS-derived anatomical information for the assessment of myocardial ischemia. The aims of this study were to investigate the relationship between wire-based FFR and IVUS-derived FFR (IVUS-FFR) and to compare the usefulness of IVUS-FFR and IVUS-derived MLA for functional assessment. Methods and Results:We retrospectively analyzed 50 lesions in 48 patients with coronary stenosis who underwent IVUS and FFR simultaneously. IVUS-FFR was calculated using our original algorithm and fluid dynamics. Mean percent diameter stenosis determined on quantitative coronary angiography and on FFR was 56.4±10.7 and 0.69±0.08, respectively. IVUS-FFR had a stronger linear correlation with FFR (R=0.78, P<0.001; root mean square error, 0.057 FFR units) than with IVUS-derived MLA (R=0.43, P=0.002).Conclusions: IVUS-FFR may be a more valuable method to identify myocardial ischemia, compared with IVUS-derived MLA.

show abstract

Section: Discussionmentioning

confidence: 99%

Intravascular Ultrasound-Derived Virtual Fractional Flow Reserve for the Assessment of Myocardial Ischemia

Seike

Uetani

Nishimura

et al. 2018

Circ J

View full text Add to dashboard Cite

show abstract

“…They found no significant correlation between FFR and the OCT measured MLA (r = 0.167, P = 0.56), MLD (r = -0.42, P = 0.13), and %AS (r = 0.29, P = 0.29). Recently, Gonzalo, et al 19) evaluated the diagnostic efficiency of OCT derived lumen measurements in identifying the stenosis severity in 56 patients with 61 stenoses. They reported poor but significant correlation between FFR and OCT measured MLA (r = 0.51, P < 0.001), MLD (r = 0.4, P = 0.005), and %AS (r = 0.33, P = 0.02).…”

Section: Discussionmentioning

confidence: 99%

Feasibility of Intracoronary Frequency Domain Optical Coherence Tomography Derived Fractional Flow Reserve for the Assessment of Coronary Artery Stenosis

2014

View full text Add to dashboard Cite

SummaryFrequency domain optical coherence tomography (FD-OCT) provides cross-sectional images of coronary arteries and deployed stents with micron resolution and measures lumen dimensions with excellent reproducibility. FD-OCT combined with a blood flow resistances model can overcome many limitations of conventional measures of stenosis severity based on quantitative coronary angiography (QCA) and intravascular ultrasound (IVUS). The aim of this feasibility study was to investigate the relationship between pressure derived fractional flow reserve (FFR) and FD-OCT derived FFR, a new method for quantitative measure of stenosis severity that estimates the blood flow resistance and microvascular resistance of the vessel segments imaged by FD-OCT. A total of 26 coronary stenoses in 20 patients were studied consecutively with QCA, pressure derived FFR, and FD-OCT. There was a moderate but significant correlation between pressure derived FFR and FD-OCT derived FFR (r = 0.69, P < 0.001). Bland-Altman analysis showed that the mean differences between pressure derived FFR and FD-OCT derived FFR were 0.05 ± 0.14 (limits of agreement: -0.09 to 0.19). The root mean square error (RMSE) between FD-OCT derived FFR and pressure derived FFR was found to be ± 0.087 FFR units. FD-OCT derived FFR has the potential to become a valuable tool for the assessment of coronary artery stenosis. ( 1-4) Intracoronary optical coherence tomography (OCT) provides cross-sectional images of coronary arteries and deployed stents with resolution 10-15 times higher than intravascular ultrasound (IVUS). OCT is used for anatomic and morphological assessment of coronary stenosis and provides lumen measurements with excellent reproducibility. [5][6][7][8] OCT also provides information about plaque vulnerability, calcification, and other parameters which helps in guiding the procedure along with diagnostics. The frequency domain OCT (FD-OCT) systems provide faster image acquisition speeds, higher frame rates, and greater scan depths as compared to time domain OCT (TD-OCT) systems. FD-OCT combined with a blood flow model can overcome many limitations of conventional measures of stenosis severity based on QCA and IVUS. The main objective of this feasibility study was to investigate the potential of FD-OCT derived FFR for the assessment of coronary artery stenosis. Through the volumetric analysis of FD-OCT images, FFR was calculated from the blood flow resistance and the microvascular resistance. A comparison between FD-OCT derived FFR and pressure derived FFR was also conducted in this study. MethodsA total of 26 coronary stenoses in 20 patients with stable angina and/or ischemia documented on exercise stress test were studied consecutively with QCA, pressure derived FFR, and FD-OCT during diagnostic coronary angiography. The study was approved by Galway clinical research ethics committee and informed consent for all procedures was obtained from each patient. Eligible patients had a single de novo stenosis in a native coronary artery with diameter stenosis...

show abstract

“…Its higher spatial resolution may offer much clearer identification of the lumen border, but very little data are available concerning the efficacy of OCT findings in assessing the significance of a stenosis. 12 In this issue of the Journal, Shiono et al 13 attempt to address this issue by comparing OCT findings with FFR. They found that MLA, minimum lumen diameter (MLD) and percent lumen area stenosis measured by OCT correlated well with FFR values; the best cutoff values measured by OCT to identify stenoses with Anatomical and Functional Assessments of Stenosis FFR <0.75 were 1.91 mm 2 , 1.35 mm and 70.0%, respectively.…”

Section: Article P 2218mentioning

confidence: 99%

“…However, using frequency-domain OCT, the optimal cutoff value of MLA to predict FFR <0.80 was determined to be 1.95 mm 2 , which was also lower than the IVUS-derived cutoff value. 12 There appear to be fundamental differences between the OCT and IVUS measurements of MLA.…”

Section: Article P 2218mentioning

confidence: 99%

Relationship Between Anatomical and Functional Assessments of Coronary Artery Stenosis

Tanaka

2012

Circ J

View full text Add to dashboard Cite

Morphometric Assessment of Coronary Stenosis Relevance With Optical Coherence Tomography

Abstract: OCT has a moderate diagnostic efficiency in identifying hemodynamically severe coronary stenoses. Although OCT seems slightly superior to IVUS for this purpose (particularly in vessels <3 mm), its low specificity precludes its use as a substitute of FFR for functional stenosis assessment.

Cited by 188 publications

References 24 publications

Intravascular Ultrasound-Derived Virtual Fractional Flow Reserve for the Assessment of Myocardial Ischemia

Intravascular Ultrasound-Derived Virtual Fractional Flow Reserve for the Assessment of Myocardial Ischemia

Feasibility of Intracoronary Frequency Domain Optical Coherence Tomography Derived Fractional Flow Reserve for the Assessment of Coronary Artery Stenosis

Relationship Between Anatomical and Functional Assessments of Coronary Artery Stenosis

Contact Info

Product

Resources

About