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Bypass Surgery or Stenting for Left Main Coronary Artery Disease in Patients With Diabetes Effect of Intravascular Ultrasound-Guided Drug-Eluting Stent Implantation: Five-Year Follow-Up of the IVUS-XPL Randomized Trial Positive remodelling of coronary arteries on computed tomography coronary angiogram: an observational study Intravascular ultrasound guidance to minimize the use of iodine contrast in percutaneous coronary intervention: the MOZART (Minimizing cOntrast utiliZation With IVUS Guidance in coRonary angioplasTy) randomized controlled trial Left Main Revascularization With PCI or CABG in Patients With Chronic Kidney Disease: EXCEL Trial Therapeutic Options for In-Stent Restenosis The Utility of Contrast Medium Fractional Flow Reserve in Functional Assessment Of Coronary Disease in Daily Practice In vivo intravascular ultrasound-derived thin-cap fibroatheroma detection using ultrasound radiofrequency data analysis Outcomes After Left Main Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting According to Lesion Site Results From the EXCEL Trial Diagnosis of Nonischemic Stage B Heart Failure in Type 2 Diabetes Mellitus: Optimal Parameters for Prediction of Heart Failure
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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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