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Volumetric characterization of human coronary calcification by frequency-domain optical coherence tomography

Original Research | By Mehanna E, Bezerra HG, Prabhu D et al.

BACKGROUND - Coronary artery calcification (CAC) presents unique challenges for percutaneous coronary intervention. Calcium appears as a signal-poor region with well-defined borders by frequency-domain optical coherence tomography (FD-OCT). The objective of this study was to demonstrate the accuracy of intravascular FD-OCT to determine the distribution of CAC. METHODS AND RESULTS - Cadaver...

Assessment of the coronary calcification by optical coherence tomography

Original Research | By Kume T, Okura H, Kawamoto T et al.

AIMS - Optical coherence tomography (OCT) can delineate calcified plaque without artefacts. The aim of this study was to evaluate the ability of OCT to quantify calcified plaque in ex vivo human coronary arteries. METHODS AND RESULTS - Ninety-one coronary segments from 33 consecutive human cadavers were examined. By intravascular ultrasound (IVUS), 32 superficial calcified plaques, defined as the leading edge of the...

Treatment of calcified coronary lesions with Palmaz-Schatz stents. An intravascular ultrasound study

Clinical Trial | By Hoffmann R, Mintz GS, Popma JJ et al.

AIMS - To evaluate the result of coronary stenting in calcified lesions and to find morphological and procedural factors influencing the final result. METHODS AND RESULTS - Three hundred and twenty three native coronary artery lesions in 303 patients (197 men, mean age 63.9 +/- 11.5 years) treated with Palmaz-Schatz stents were differentiated into four groups depending on their degree of circumferential calcific...

Attenuated plaque detected by intravascular ultrasound: clinical, angiographic, and morphologic features and post-percutaneous coronary intervention complications in patients with acute coronary syndromes

Review Article | By Lee SY, Mintz GS, Kim SY et al.

OBJECTIVES - We evaluated the clinical significance of attenuated plaque (hypoechoic plaque with deep ultrasound attenuation). BACKGROUND - Attenuated plaques are unusual intravascular ultrasound (IVUS) findings in patients with acute coronary syndrome (ACS). METHODS - We reviewed clinical presentations and angiographic and pre-intervention IVUS findings in 293 ACS patients undergoing per...

Superficial Calcium Fracture After PCI as Assessed by OCT

Letter | By Kubo T, Shimamura K, Ino Y et al.

Heavily calcified lesions in coronary arteries have been known to cause stent underexpansion, which increases the risk of in-stent restenosis. Plaque modification before stent implantation is considered to be the key for treatment of calcified lesions. We hypothesized that calcium fracture by percutaneous coronary intervention (PCI) might be associated with adequate stent expansion and favorable late outcome. From the coronary cathet...

A new optical coherence tomography-based calcium scoring system to predict stent underexpansion

Original Research | By Fujino A, Mintz GS, Matsumura M et al.

AIMS - This was a retrospective study to develop and validate an optical coherence tomography (OCT)-based calcium scoring system to predict stent underexpansion. METHODS AND RESULTS - A calcium score was developed using 128 patients with pre- and post-stent OCT (test cohort) and then validated in an external cohort of 133 patients. In the test cohort, a multivariable model showed that the independent predictors ...

Atherosclerotic plaque with ultrasonic attenuation affects coronary reflow and infarct size in patients with acute coronary syndrome: an intravascular ultrasound study

Original Research | By Okura H, Taguchi H, Kubo T et al.

BACKGROUND - No reflow following percutaneous coronary intervention (PCI) is a major concern in patients with acute coronary syndrome (ACS) and it may be influenced by the preexisting plaque type. METHODS AND RESULTS - To evaluate the impact of plaque characteristics on coronary reflow following PCI in patients with ACS, a total of 110 patients (89 acute myocardial infarction, 21 unstable...

The relationship between attenuated plaque identified by intravascular ultrasound and no-reflow after stenting in acute myocardial infarction: the HORIZONS-AMI (Harmonizing Outcomes With Revascularization and Stents in Acute Myocardial Infarction) trial

Original Research | By Wu X, Mintz GS, Xu K et al.

OBJECTIVES - The aim of this study was to understand the impact of attenuated plaque on distal embolization during stent implantation in patients with acute myocardial infarction (AMI). BACKGROUND - Attenuated plaques identified by grayscale intravascular ultrasound (IVUS) might predict transient deterioration in coronary flow and/or no-reflow during percutaneous coronary intervention (PCI). ...

Plaque composition by intravascular ultrasound and distal embolization after percutaneous coronary intervention

Review Article | By Claessen BE, Maehara A, Fahy M et al.

Distal embolization after percutaneous coronary intervention occurs in 15% to 70% of patients, depending on the sensitivity of the diagnostic modality used, and is associated with a poor prognosis after elective and primary percutaneous coronary intervention. It has been hypothesized that imaging of the plaque composition can identify coronary artery lesions that are predisposed to causing distal embolization. This review report aims to summarize al...

Impact of plaque components on no-reflow phenomenon after stent deployment in patients with acute coronary syndrome: a virtual histology-intravascular ultrasound analysis

Original Research | By Hong YJ, Jeong MH, Choi YH et al.

AIMS - We used virtual histology-intravascular ultrasound (VH-IVUS) to evaluate the relation between coronary plaque characteristics and no-reflow in acute coronary syndrome (ACS) patients. METHODS AND RESULTS - A total of 190 consecutive ACS patients were imaged using VH-IVUS and analysed retrospectively. Angiographic no-reflow was defined as TIMI flow grade 0, 1, and 2 after stenting. Virtual...

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