Author + information
- Christian Bo Poulsena,b,
- Ryan Pedrigia,b,
- Niels Holma,b,
- Nilesh Pareeka,b,
- Ismail Kilica,b,
- Anouk L. Posta,b,
- Carlo Di Marioa,b,
- Jacob Bentzona,b,
- Hans Botkera,b,
- Erling Falka,b,
- Rob Kramsa,b and
- Ranil de Silvaa,b
Background: In vivo validation of optical coherence tomography (OCT) against histology and the effects of plaque burden (PB) on plaque classification remain unreported. We investigated this in a porcine model with human-like coronary atherosclerosis.
Methods: Five female Yucatan D374Y-PCSK9 transgenic hypercholesterolemic mini-pigs were implanted with a coronary shear-modifying stent to induce advanced atherosclerosis. OCT frames (n=151) were obtained 34 weeks after implantation. Post mortem, the coronary arteries were perfusion-fixed, serially sectioned and co-registered with OCT using a validated algorithm. Lesion were adjudicated, using the Virmani classification and PB assessed from histology.
Result: OCT had a high sensitivity but modest specificity (92.0% and 69.0%), for identifying fibrous cap atheroma (FCA). The reduced specificity for OCT was due to misclassification of plaques with histologically defined pathological intimal thickening (PIT) as FCA (42.0% of the frames with histological PIT were misclassified). PIT lesions misclassified as FCA by OCT had a statistically higher PB than in other OCT frames (median 43.5% versus 13.5%; p<0.0001). Misclassification of PIT lesions by OCT occurred when PB exceeded 22.3%.
Conclusions: Compared with histology, in vivo OCT classification of FCA had high sensitivity but reduced specificity due to misclassification of PIT's with high PB.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Interventional Cardiology: Translation and Pre-Clinical Research
Abstract Category: 25. Interventional Cardiology: Translation and Pre-clinical Research
Presentation Number: 1116-193
- 2017 American College of Cardiology Foundation