Author + information
- Omeed Neghabat1,
- Trine Ørhøj Barkholt2,
- Jeffrey Anderson3,
- Jo Simonsen1,
- Emil Holck4 and
- Niels Holm1
Three-dimensional (3D) intravascular optical coherence tomography (OCT) is available for online guiding during percutaneous coronary intervention and could be of particular value in detection of acute stent fracture (SF). OCT artifacts mimicking fractured stent struts are a limitation for this application calling for physician awareness about such artifacts.
OCT scans from coronary arteries implanted with a fully bioresorbable scaffold (FANTOM, REVA Medical, San Diego, CA, USA) were analyzed for fractures after 3D rendering. The FANTOM scaffold is readily visualized in 3D OCT and allows for clear visualization of the struts. Identification of apparently discontinued struts led to careful evaluation of the scan for potential artifacts including wire shadows, overlying tissue or thrombus, rotational artifacts, and other volume rendering errors.
In 65 patients with fully analyzable 3D OCT we identified 39 (60%) cases with artifacts resembling strut fractures. Among these were 14 (36%) due to rotational artifacts, 12 (31%) due to longitudinal compressed image distortion, 6 (15%) due to unflushed blood, 4 (10%) due to console error, two (5%) due to longitudinal elongated image distortion, and one (3%) due to a wobbling wire artifact.
In-procedure detection of strut fracture by 3D OCT may emerge as gold standard in treatment with bioresorbable scaffolds but to avoid unnecessary intervention, physicians should be able to rule out frequent artifacts mimicking fractures.
IMAGING: Imaging: Intravascular