The role of optical coherence tomography in guiding percutaneous coronary interventions: is left main the final challenge?

Onea, Horea-Laurentiu; Lazar, Florin-Leontin; Olinic, Dan-Mircea; Homorodean, Călin; Cortese, Bernardo

doi:10.23736/s2724-5683.22.06181-6

Cited by 4 publications

(2 citation statements)

References 83 publications

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“…Intravascular imaging, mainly through optical coherence tomography (OCT), represents a useful diagnostic tool in the setting of ACS, providing good analytical capacity for culprit plaque morphology and can even detect non-atherosclerotic lesions. Equally as important, this technique can help guide percutaneous coronary interventions (PCI) from procedure indication, choice of adequate treatment strategy and advanced stent optimization and complication management [ 2 , 3 , 4 , 5 , 6 , 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Superficial Calcified Plates Associated to Plaque Erosions in Acute Coronary Syndromes

Onea

Spînu

Homorodean

et al. 2023

Life

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This study investigates the clinical relevance and therapeutic implications of the OCT identification of intracoronary superficial calcified plates (SCPs) in acute coronary syndromes (ACSs). In 70 consecutive ACS patients (pts), we studied the three main underlying ACS mechanisms: plaque erosion (PE), plaque rupture and eruptive calcified nodule (CN). The PE lesions, occurring on an intact fibrous cap overlying a heterogeneous substrate, were identified in 12/70 pts (17.1%). PE on superficial calcified plates (PE-SCP) represented 58.3% of the PE lesions (7/12 pts) and had a 10% overall incidence in the culprit lesions (7/70 pts). PE-SCP lesions occurred mostly on the left anterior descending artery, correlated with white thrombi (85.7%) and had a proximal intraplaque site (71.4%). PE-SCP lesions were treated conservatively, as nonsignificant lesions, in 4/7 pts. Our study emphasizes that the coronary calcium-related ACS risk is not only associated with the spotty calcifications or CN but also with the PE-SCP lesions.

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Section: Introductionmentioning

confidence: 99%

Superficial Calcified Plates Associated to Plaque Erosions in Acute Coronary Syndromes

Onea

Spînu

Homorodean

et al. 2023

Life

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“…By means of different backscattering and attenuation properties, each tissue component offers a specific OCT image. OCT provides invaluable insights in the setting of ACS [ 3 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 ] by allowing the exclusion of non-atherosclerotic causes [ 9 , 10 , 11 ] as well as defining the vulnerable plaque by evaluating the fibrous cap thickness and degree of macrophage infiltration [ 4 ]. Equally important, it can assess the culprit atherosclerotic lesions, with its favorable ability in detecting plaque erosion (PE), plaque rupture (PR) [ 21 ], or due to adequate calcium penetration, the calcified nodule (CN) [ 22 ].…”

Section: Introductionmentioning

confidence: 99%

Distinctive Morphological Patterns of Complicated Coronary Plaques in Acute Coronary Syndromes: Insights from an Optical Coherence Tomography Study

et al. 2022

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Optical coherence tomography (OCT) is an ideal imaging technique for assessing culprit coronary plaque anatomy. We investigated the morphological features and mechanisms leading to plaque complication in a single-center observational retrospective study on 70 consecutive patients with an established diagnosis of acute coronary syndrome (ACS) who underwent OCT imaging after coronary angiography. Three prominent morphological entities were identified. Type I or intimal discontinuity, which was found to be the most common mechanism leading to ACS and was seen in 35 patients (50%), was associated with thrombus (68.6%; p = 0.001), mostly affected the proximal plaque segment (60%; p = 0.009), and had no distinctive underlying plaque features. Type II, a significant stenosis with vulnerability features (inflammation in 16 patients, 84.2%; thin-cap fibroatheroma (TCFA) in 10 patients, 52.6%) and a strong association with lipid-rich plaques (94.7%; p = 0.002), was observed in 19 patients (27.1%). Type III, a protrusive calcified nodule, which was found to be the dominant morphological pattern in 16 patients (22.9%), was found in longer plaques (20.8 mm vs. 16.8 mm ID vs. 12.4 mm SS; p = 0.04) and correlated well with TCFA (93.8%; p = 0.02) and inflammation (81.3%). These results emphasize the existence of a wide spectrum of coronary morphological patterns related to ACS.

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Acute and long-term results of percutaneous coronary intervention of bifurcation lesions with the dedicated Bioss Lim C stent: the Italian BIfurcation Observational Spontaneous Study (IBIOSS)

BRIGUORI,

CAPODANNO,

CONTARINI

et al. 2024

Minerva Med

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The role of optical coherence tomography in guiding percutaneous coronary interventions: is left main the final challenge?

Cited by 4 publications

References 83 publications

Superficial Calcified Plates Associated to Plaque Erosions in Acute Coronary Syndromes

Superficial Calcified Plates Associated to Plaque Erosions in Acute Coronary Syndromes

Distinctive Morphological Patterns of Complicated Coronary Plaques in Acute Coronary Syndromes: Insights from an Optical Coherence Tomography Study

Acute and long-term results of percutaneous coronary intervention of bifurcation lesions with the dedicated Bioss Lim C stent: the Italian BIfurcation Observational Spontaneous Study (IBIOSS)

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