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Restricted access Mortality After Repeat Revascularization Following PCI or CABG for Left Main Disease: The EXCEL Trial Autologous CD34+ Stem Cell Therapy Increases Coronary Flow Reserve and Reduces Angina in Patients With Coronary Microvascular Dysfunction Outcomes of patients with and without baseline lipid-lowering therapy undergoing revascularization for left main coronary artery disease: analysis from the EXCEL trial Machine Learning Using CT-FFR Predicts Proximal Atherosclerotic Plaque Formation Associated With LAD Myocardial Bridging Pulmonary vascular lesions occurring in patients with chronic major vessel thromboembolic pulmonary hypertension C-reactive protein and prognosis after percutaneous coronary intervention and bypass graft surgery for left main coronary artery disease: Analysis from the EXCEL trial Comprehensive Management of Cardiovascular Risk Factors for Adults With Type 2 Diabetes: A Scientific Statement From the American Heart Association Attenuated Mitral Leaflet Enlargement Contributes to Functional Mitral Regurgitation After Myocardial Infarction Parallel Murine and Human Plaque Proteomics Reveals Pathways of Plaque Rupture Angiographic derived endothelial shear stress: a new predictor of atherosclerotic disease progression
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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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