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Management of Myocardial Revascularization Failure: An Expert Consensus Document of the EAPCI Improved outcomes in patients with ST-elevation myocardial infarction during the last 20 years are related to implementation of evidence-based treatments: experiences from the SWEDEHEART registry 1995-2014 Association of Acute Procedural Results with Long-term Outcomes After CTO-PCI Vascular response and healing profile of everolimus-eluting bioresorbable vascular scaffolds for percutaneous treatment of chronic total coronary occlusions: A one-year optical coherence tomography analysis from the GHOST-CTO registry Impact of Optimized Procedure-Related Factors in Drug-Eluting Balloon Angioplasty for Treatment of In-Stent Restenosis Short-term and long-term clinical outcomes of rotational atherectomy in resistant chronic total occlusion Contemporary Diagnosis and Management of Patients With Myocardial Infarction in the Absence of Obstructive Coronary Artery Disease: A Scientific Statement From the American Heart Association Effect of a Restrictive vs Liberal Blood Transfusion Strategy on Major Cardiovascular Events Among Patients With Acute Myocardial Infarction and Anemia: The REALITY Randomized Clinical Trial Clinical Characteristics and Outcomes of STEMI Patients With Cardiogenic Shock and Cardiac Arrest Epidemiology and Clinical Outcomes of Patients With Inflammatory Bowel Disease Presenting With Acute Coronary Syndrome
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Review Article2018 Sep;72(3):179-185.

JOURNAL：J Cardiol. Article Link

Histopathological validation of optical coherence tomography findings of the coronary arteries

Fujii K, Kawakami R, Hirota S. Keywords: atherosclerosis; OCT; Stent; histopathological validation

ABSTRACT

Optical coherence tomography (OCT), a catheter-based imaging modality for the visualization of coronary arteries, is widely used during percutaneous coronary intervention to improve the understanding of the anatomy of coronary artery stenosis and to elucidate the mechanisms of atherosclerosis. In this review, we provide a short description of the histopathological validations of OCT for visualizing atherosclerotic plaques and vascularhealing response after drug-eluting stent (DES) implantation. Because OCT measures the intensity of light returning from within a tissue, tissue having a higher heterogeneity of optical index of refraction, such as microcalcification deposition and foam cell accumulation on the luminal surface, may exhibit stronger optical scattering that appears as a thin-cap fibroatheroma image. Furthermore, even if OCT shows exposed uncovered stent struts, some of the struts could be re-endothelialized. In our ex vivo histopathological experience, re-endothelialization at the surface of stent struts was confirmed by histopathological analysis, although OCT images showed exposed uncovered struts after DES implantation. Therefore, careful interpretation is required to assess tissue morphology and stent strut coverage by OCT.

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