Frequency‐domain optical coherence tomography assessment of unprotected left main coronary artery disease—a comparison with intravascular ultrasound

Catheterization and Cardiovascular Interventions - Tập 82 Số 3 - 2013
Yusuke Fujino1,2, Hiram G. Bezerra2, Guilherme F. Attizzani2, Wei Wang2, Hirosada Yamamoto2, Daniel Chamié2, Tomoaki Kanaya2, Emile Mehanna2, Satoko Tahara1, Sunao Nakamura1, Marco A. Costa2
1Department of Cardiology, New Tokyo Hospital, Chiba, Japan
2Harrington Heart and Vascular Institute, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio

Tóm tắt

ObjectivesTo investigate safety and feasibility of imaging unprotected left main (ULM) using frequency‐domain optical coherence tomography (FD‐OCT) compared with intravascular ultrasound (IVUS).BackgroundIVUS has been used to assess and guide percutaneous coronary intervention (PCI) of ULM disease. FD‐OCT offers 10‐fold higher axial resolution than IVUS and its high‐speed image acquisition obviates the need for proximal balloon occlusion.MethodsWe prospectively enrolled 35 consecutive patients with ULM disease. FD‐OCT and IVUS assessments were attempted pre‐ and post‐PCI and compared in regards to safety, ability to image the region of interest (ROI), number of pullbacks, volume of contrast and ability to detect malapposition, dissection, and thrombus.ResultsPatients were followed for 1 year when FD‐OCT imaging was repeated. FD‐OCT required more repeated pullbacks to image the ROI compared to IVUS. Mean lumen and stent areas were similar between FD‐OCT and IVUS (11.24 ± 2.66 vs. 10.85 ± 2.47 mm2, P = 0.13 and 10.44 ± 2.33 vs. 10.49 ± 2.32 mm2, P = 0.82, respectively), whereas imaged stent length was shorter with FD‐OCT. Malapposition areas and volumes were larger and more edge dissections were detected by FD‐OCT. There were no clinical adverse events and no complications associated with FD‐OCT at baseline and 1‐year follow‐up. All dissections were healed, whereas stent malapposition was still detected at follow‐up.ConclusionsFD‐OCT assessment of ULM is feasible and safe. Direct comparisons with IVUS reveal that FD‐OCT achieved imaging completeness less often, whereas it was more sensitive in detecting malapposition and edge dissections, and similar to IVUS in the assessment of lumen and stent dimensions. © 2013 Wiley Periodicals, Inc.

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Catheterization and Cardiovascular Interventions

Tập 82 Số 3

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