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Optical Coherence Tomography (OCT) coronary imaging requires displacement of the red blood cells from the vessel lumen during image acquisition. This is usually accomplished using radiographic contrast, which is costly and carries risk for contrast nephropathy. Low molecular weight dextran has low cost and is safe in low volumes (< 1,000 mL). In the present study, we compared dextran with contrast for coronary OCT imaging.
Twenty–eight vessels in 15 patients were sequentially imaged using manual injection of radiographic contrast (iodixanol, GE Healthcare, Princeton, New Jersey) and dextran. OCT images were analyzed at 1 mm intervals to determine the clarity of imaging (defined as a visible lumen boarder > 270°) and to measure the lumen area.
A total of 1,962 cross–sections (981 obtained using contrast and 981 obtained using dextran) were analyzed. The injected volume of iodixanol and dextran per imaging run was 13.2±2.27 ml and 18.1±2.60 ml, respectively (P < 0.001). There were no complications related to contrast or dextran administration or to OCT imaging. Clear image segments were observed in 96.7 % vs 96.6% of the cross–sections obtained with contrast and dextran, respectively (P = 0.91). The mean lumen areas were also similar: 6.86±2.10 mm2with iodixanol and 6.55±1.95 mm2with dextran (P = 0.58; correlation coefficient 0.96; 95% confidence interval, 0.92 to 0.98).
The image quality and measurements during OCT image acquisition are similar for dextran and contrast. Dextran could be used instead of contrast for OCT imaging, especially in patients in whom contrast load minimization is desired.
Poster Sessions, Expo North
Sunday, March 10, 2013, 9:45 a.m.–10:30 a.m.
Session Title: Intravascular Imaging: IVUS and OCT
Abstract Category: 38. TCT@ACC–i2: Intravascular Imaging and Physiology
Presentation Number: 2108–239
- 2013 American College of Cardiology Foundation