Natural History of Stent Edge Dissection, Tissue Protrusion and Incomplete Stent Apposition Detectable Only on Optical Coherence Tomography After Stent Implantation

Kume, Teruyoshi; Okura, Hiroyuki; Miyamoto, Yoshinori; Yamada, Ryotaro; Saito, Ken; Tamada, Tomoko; Koyama, Terumasa; Neishi, Yoji; Hayashida, Akihiro; Kawamoto, Takahiro; Yoshida, Kiyoshi

doi:10.1253/circj.cj-11-0845

Cited by 83 publications

(64 citation statements)

References 31 publications

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“…The clinical significance of these OCT findings and whether they warrant further intervention remains unclear; with a small natural history study showing that these findings resolved without significant restenosis or thrombus formation at six-month follow-up. 37 To date, no studies have been completed investigating the role of OCT in optimising PCI for non-ST-segment elevation acute coronary syndromes (NSTEACS). The Does Optical Coherence Tomography Optimise Results of Stenting (DOCTORS) study will randomise 250 patients to have OCT-guided angioplasty or angioplasty alone.…”

Section: Optimising Percutaneous Coronary Interventionmentioning

confidence: 99%

Intravascular Ultrasound Versus Optical Coherence Tomography for Coronary Artery Imaging – Apples and Oranges?

Rathod¹,

Hamshere²,

Jones³

et al. 2015

Interventional Cardiology Review

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Coronary angiography has been the gold standard technique for evaluating coronary arterial disease for the past 50 years. Increasingly, however, realisation of the limitations of coronary angiography, mainly the inability to supply information regarding the coronary wall, has prompted the design and development of adjunctive technologies to better evaluate not just luminal disease but also the burden and character of atherosclerotic plaque within the vessel. The development of intracoronary imaging modalities, namely intravascular ultrasound (IVUS) and optical coherence tomography (OCT), has progressed quickly and these technologies now have established roles in the diagnosis and treatment of coronary artery disease. In general, intracoronary devices that can assess the coronary endothelium use either acoustic or optical signals that are received by a coronary catheter (IVUS uses ultrasound, OCT uses near-infrared light).This review addresses these two widely used intracoronary imaging techniques, looking at their clinical applications, recent evidence for their use and describes new developments in the field. Intravascular UltrasoundIn the last 25 years IVUS has been established as the most commonly used intracoronary imaging device. An IVUS system consists of a flexible monorail catheter with an ultrasound transducer at its tip that emits ultrasound waves in the 10-40 MHz range and an electronics console to reconstruct the image (see Figure 1).1 After reflection from tissue, part of the ultrasound energy returns to the transducer and is converted into the image.There are two types of IVUS transducers for clinical use: the mechanical rotating transducer and the electronically switched phased array system.The mechanical transducer uses a single crystal on a rotational device, which visualises the entire vessel in cross-section providing better image quality (compared with phased array technology) of 100-150 μm.2 The main disadvantage of mechanical transducers is the central drive shaft that decreases flexibility and prevents the concurrent use of a central guidewire.3 However, newer rotational IVUS catheters have developed a monorail system that allows for the presence of a central guidewire.Phased array catheters use multiple transducer elements, which are mounted along the circumference of the catheter tip. Each element sends and receives ultrasounds from a sector and multiple sectors are gathered to produce a cross-sectional image of the artery. However, they are disadvantaged by a technically complex set-up, requiring detailed programming; 3 but some of the newer catheters are easier to set up.Intracoronary imaging of coronary vessels by IVUS is performed using standard coronary interventional techniques and equipment (guiding catheter and 0.014 inch angioplasty guidewire) for catheter delivery along the guidewire beyond the target lesion/area of interest. Intravenous heparin and glyceryl trinitrate (nitroglycerin) are routinely administered before imaging. The IVUS catheter is then drawn back across the tar...

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Section: Optimising Percutaneous Coronary Interventionmentioning

confidence: 99%

Intravascular Ultrasound Versus Optical Coherence Tomography for Coronary Artery Imaging – Apples and Oranges?

Rathod¹,

Hamshere²,

Jones³

et al. 2015

Interventional Cardiology Review

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show abstract

“…When there is no narrowing of the true lumen, an additional procedure may not be required for the treatment of coronary dissection. 17 In addition, stent edge dissection could occur more frequently when the OCT-derived plaque type at the edge of the stent is fibrocalcific (44%) or lipid-rich (38%) than when the plaque is fibrous (10%) (P=0.009). 20 OCT is a useful tool for predicting coronary dissection during PCI.…”

Section: Coronary Dissectionmentioning

confidence: 99%

“…OCT in PCI could be covered by neointima during long-term follow-up. 17 However, stent struts with a huge malapposition may be a risk for stent thrombosis. 18 …”

Section: Stent Malappositionmentioning

confidence: 99%

Application of Optical Coherence Tomography in Percutaneous Coronary Intervention

Kubo

Tanaka

Kitabata

et al. 2012

Circ J

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“…Coronary dissection is frequently observed at the distal stent edge because of the oversized stent diameter or complex types of plaque at the stent edge by OCT. When there is no limited coronary flow by angiography and adequate area of the true lumen by OCT, no additional procedure might be necessary for the treatment of coronary dissection [15].…”

Section: Clinical Applications Of Oct Imagingmentioning

confidence: 99%

“…To check the stent apposition to the vessel wall, the distance between surface of stent strut and adjacent inatima border should be measured because of differences of stent and polymer thickness [8]. Small ISA, which is detected by only OCT but not by IVUS, could disappear by neointimal growth during follow-up period [15].…”

Section: Clinical Applications Of Oct Imagingmentioning

confidence: 99%

Clinical and Research Applications of Optical Coherence Tomography Imaging in Coronary Artery Disease

Hasegawa¹,

Shimada²

2013

What Should We Know About Prevented, Diagnostic, and Interventional Therapy in Coronary Artery Disease

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Natural History of Stent Edge Dissection, Tissue Protrusion and Incomplete Stent Apposition Detectable Only on Optical Coherence Tomography After Stent Implantation

Cited by 83 publications

References 31 publications

Intravascular Ultrasound Versus Optical Coherence Tomography for Coronary Artery Imaging – Apples and Oranges?

Intravascular Ultrasound Versus Optical Coherence Tomography for Coronary Artery Imaging – Apples and Oranges?

Application of Optical Coherence Tomography in Percutaneous Coronary Intervention

Clinical and Research Applications of Optical Coherence Tomography Imaging in Coronary Artery Disease

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