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

Abstract

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.

Coronary calcification segmentation in intravascular OCT images using deep learning: application to calcification scoring

“…As quoting from their manuscript: "we assigned 1 or 2 points to each of three conditions: 2 points for maximum calcium angle >180°, 1 point for maximum calcium thickness >0.5 mm, and 1 point for calcium length >5 mm." 13 In their study, they found that lesions with calcification score of 0 to 3 had "adequate stent expansion," whereas lesions with a score of 4 had "poor stent expansion. "…”

“…Plaque length is the total length (number of frames × frame interval) over which the calcification spans. We used the method described by Fujino et al 13 for determining the stent deployment calcification score. The idea of calcification scoring is to define lesions that would benefit from plaque modification prior to stent implantation.…”

“…Table 3 IVOCT-based calcification scoring for representative lesions. We used the calcification scoring system developed by Fujino et al 13 on five held out lesions and compared manual and automated measurements. Scores are based on lesion length, maximum thickness, and maximum angle.…”

Treating severely calcified coronary artery disease: A potpourri of choices!

“…With its higher spatial resolution and absence of acoustic shadowing, optical coherence tomography (OCT) offers a greater advantage over intravascular ultrasound in defining calcific burden not only in terms of degree of the calcific arch but also calcium thickness and length . This has been shown to provide crucial information for planning an upfront lesion preparation strategy to facilitate plaque modification and prevent stent underexpansion …”

Comparação randomizada de intervenções coronárias percutâneas guiadas por tomografia de coerência óptica versus ultrassom intravascular versus angiografia: Estudo randomizado iSIGHT

“…Em outros relatos, cálcios com espessura < 0,5 mm associaram-se com maior possibilidade de fratura durante dilatação com balão, independentemente da sua distribuição circunferencial, o que, por sua vez, resultou em melhor expansão dos stents implantados em comparação com os vasos em que não se obteve fratura dos cálcios (52,53) . Mais recentemente, Fujino e et al (54) desenvolveram um escore para graduação da calcificação coronária em uma coorte de 128 pacientes submetidos a TCO pré e pós implante de stents (coorte teste), validada em uma coorte externa de…”