Application of optical coherence tomography in interventional diagnosis and treatment of borderline coronary artery disease
- VernacularTitle:光学相干断层成像在冠状动脉临界病变介入诊断与治疗中的应用
- Author:
Zhigang HAN
;
Guanghua GAO
;
Rui WANG
- Publication Type:Journal Article
- Keywords:
Optical coherence tomography;
Coronary disease;
Angioplasty,transluminal,percutaneous coronary;
Stent
- From:
Chinese Journal of Interventional Cardiology
1993;0(02):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the feasibility and efficacy of optical coherence tomography (OCT) in interventional diagnosis and treatment of borderline coronary artery disease. Methods Sixteen 40%-70% angiographically stenotic lesions from 15 patients were enrolled in the current study. Intravascular OCT was applied to each lesion after informed consent was obtained to evaluate stenosis percentage, size of lipid core, thickness of fibrous cap, existence of plaque rupture, and presence of thrombosis or calcification. Therapeutic strategies were made according to OCT outcomes as well as clinical symptoms and electrocardiographic changes. Stent coverage, apposition, and tissue prolapse between stent struts were determined in the patients undertaken percutaneous coronary intervention(PCI). Results Qualitative OCT images were obtained in 14 lesions. Ten lesions were greater than 50% stenosis, with large lipid core and fibrous cap thinner than 65 ?m, and plaque ruptures were noted in 2 of the lesions. PCI were performed in these 10 lesions. Two lesions underwent predilatation and significant intima tearings and dissections were detected with OCT. Repeated OCT after stent implantation showed complete coverage in all 10 lesions. Focal incomplete apposition were noted in 2 lesions. Significant tissue prolapse occurred in 3 lesions and segmental incomplete deployment of stent in 2 lesions. The remaining 4 lesions had small lipid cores, thick fibrous caps but with no plaque ruptures, thus PCI was not performed. Conclusion Intracoronary OCT is an effective tool to determine features of coronary lesions. It plays an important role in diagnosis of vulnerable lesions, strategy-making in treating borderline coronary artery disease and evaluation of immediate result of PCI.
