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Clinical use of intracoronary imaging. Part 1: guidance and optimization of coronary interventions. An expert consensus document of the European Association of Percutaneous Cardiovascular Interventions: Endorsed by the Chinese Society of Cardiology Spontaneous Coronary Artery Dissection: Pathophysiological Insights From Optical Coherence Tomography Impact of low tissue backscattering by optical coherence tomography on endothelial function after drug-eluting stent implantation Optical Coherence Tomography-Guided Percutaneous Coronary Intervention in ST-Segment-Elevation Myocardial Infarction: A Prospective Propensity-Matched Cohort of the Thrombectomy Versus Percutaneous Coronary Intervention Alone Trial Angiography Alone Versus Angiography Plus Optical Coherence Tomography to Guide Percutaneous Coronary Intervention: Outcomes From the Pan-London PCI Cohort Neoatherosclerosis in Patients With Coronary Stent Thrombosis: Findings From Optical Coherence Tomography Imaging (A Report of the PRESTIGE Consortium) Joint consensus on the use of OCT in coronary bifurcation lesions by the European and Japanese bifurcation clubs Coronary Artery Intraplaque Microvessels by Optical Coherence Tomography Correlate With Vulnerable Plaque and Predict Clinical Outcomes in Patients With Ischemic Angina Comparison of Coronary Intimal Plaques by Optical Coherence Tomography in Arteries With Versus Without Internal Running Vasa Vasorum Changes in Coronary Plaque Composition in Patients With Acute Myocardial Infarction Treated With High-Intensity Statin Therapy (IBIS-4): A Serial Optical Coherence Tomography Study
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Original Research2018 Apr 6;13(18):e2182-e2189.

JOURNAL：EuroIntervention. Article Link

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

Fujino A, Mintz GS, Matsumura M et al. Keywords: calcified stenosis; OCT

ABSTRACT

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 of stent expansion were maximum calcium angle per 180° (regression coefficient: -7.43; p<0.01), maximum calcium thickness per 0.5 mm (-3.40; p=0.02), and calcium length per 5 mm (-2.32; p=0.01). A calcium score was then defined as 2 points for maximum angle >180°, 1 point for maximum thickness >0.5 mm, and 1 point for length >5 mm. In the validation cohort, the lesions with calcium score of 0 to 3 had excellent stent expansion, whereas the lesions with a score of 4 had poor stent expansion (96% versus 78%, p<0.01). On multivariate analysis the calcium score was an independent predictor of stent underexpansion.

CONCLUSIONS - An OCT-based calcium scoring system can help to identify lesions that would benefit from plaque modification prior to stent implantation. Lesions with calcium deposit with maximum angle >180°, maximum thickness >0.5 mm, and length >5 mm may be at risk of stent underexpansion.
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