Author + information
- Yongqing Lina,b,
- Mitsuaki Matsumuraa,b,
- Gary Mintza,b,
- Xiao Wanga,b,
- Cheolmin Leea,b,
- Tsunekazu Kakutaa,b and
- Akiko Maeharaa,b
Background: Optical coherence tomography (OCT) has higher resolution and improved tissue characterization compared to intravascular ultrasound (IVUS).
Methods: We retrospectively analyzed 498 pts (44.1% acute coronary syndrome) who underwent stent implantation with final IVUS and OCT. Tissue protrusion (TP, any intra-stent mass ≥2mm thick) was subcategorized into 1) irregular vs smooth surface and 2) with attenuation (indicating lipid rich tissue or thrombus) vs without attenuation. Acute stent malapposition (ASM) was defined as ≥0.2mm distance from the center of the strut blooming artifact to the surface of the plaque.
Results: Although the prevalence of TP by OCT was twice that of IVUS, the detection of significant TP (≥10% stent area) was similar (Table). When we compared TP that was detected by both IVUS and OCT (n= 155), the prevalence of TP with irregular (vs smooth) surface or with (vs without) attenuation by OCT was also twice that by IVUS. While detection of any ASM by OCT was many times greater than by IVUS, (1) the improved OCT detection of large areas of ASM (≥10% stent area) was only twice as high as by IVUS and (2) ASM accompanied by stent underexpansion (stent area <90% reference lumen) was uncommon and seen with equal frequency by OCT and IVUS (2.2% vs 1.4%, p= 0.45).
Conclusions: OCT can detect TP that may predict worse outcomes (lipidic plaque or thrombus protrusion) better than IVUS. However, detection of clinically important ASM (large area with underexpansion) by OCT vs IVUS seem to be similar.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Interventional Cardiology: Stent Failure Analysis by Intravascuar Imaging
Abstract Category: 23. Interventional Cardiology: IVUS and Intravascular Physiology
Presentation Number: 1193-136
- 2017 American College of Cardiology Foundation