OCT-measured plaque free wall angle is indicative for plaque burden: overcoming the main limitation of OCT?

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• 作者：Ayla Hoogendoorn ; Muthukaruppan Gnanadesigan…
• 关键词：Optical coherence tomography ; Intravascular ultrasound ; Plaque free wall ; Plaque burden ; Stent ; landing zone
• 刊名：The International Journal of Cardiovascular Imaging (formerly Cardiac Imaging)
• 出版年：2016
• 出版时间：October 2016
• 年：2016
• 卷：32
• 期：10
• 页码：1477-1481
• 全文大小：910 KB
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Cardiology
  
• 出版者：Springer Netherlands
• ISSN：1573-0743
• 卷排序：32

文摘

The aim of this study was to investigate the relationship between the plaque free wall (PFW) measured by optical coherence tomography (OCT) and the plaque burden (PB) measured by intravascular ultrasound (IVUS). We hypothesize that measurement of the PFW could help to estimate the PB, thereby overcoming the limited ability of OCT to visualize the external elastic membrane in the presence of plaque. This could enable selection of the optimal stent-landing zone by OCT, which is traditionally defined by IVUS as a region with a PB < 40 %. PB (IVUS) and PFW angle (OCT and IVUS) were measured in 18 matched IVUS and OCT pullbacks acquired in the same coronary artery. We determined the relationship between OCT measured PFW (PFW_OCT) and IVUS PB (PB_IVUS) by non-linear regression analysis. An ROC-curve analysis was used to determine the optimal cut-off value of PFW angle for the detection of PB < 40 %. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated. There is a significant correlation between PFW_OCT and PB_IVUS (r2 = 0.59). The optimal cut-off value of the PFW_OCT for the prediction of a PB_IVUS < 40 % is ≥220° with a PPV of 78 % and an NPV of 84 %. This study shows that PFW_OCT can be considered as a surrogate marker for PB_IVUS, which is currently a common criterion to select an optimal stent-landing zone.