Evaluation of coronary arterial calcification – Ex-vivo assessment by optical frequency domain imaging

Ijichi, Takeshi; Nakazawa, Gaku; Torii, Sho; Yoshikawa, Ayako; Morino, Yoshihiro; Ikari, Yuji

doi:10.1016/j.atherosclerosis.2015.09.002

Cited by 28 publications

(15 citation statements)

References 37 publications

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“…While previous OCT studies have not assessed the relationship between location of the calcium fracture and RA modification, our study showed that 60% of calcium fracture was seen at the calcium modification site by OA. In addition, we found that the thickness of fractured calcium at the site of OA modification was thicker than the thickness of fractured calcium at sites without OA modification 22 Ijichi et al 23 confirmed that calcified plaque detected by OCT-contained lipid pools and/or necrotic cores by histology evaluation. Therefore, it is plausible that the surface of calcium may be harder (because of older or matured calcium deposits) than the center of the OCT-identified calcium and hence surface modification of calcium by OA was effective.…”

Section: Discussionsupporting

confidence: 57%

“…Pathological observations have shown that calcification is initiated in the deeper regions of the necrotic core and progress from the outer rim (ie, surface of calcium) and thus the central core may not become fully calcified . Ijichi et al confirmed that calcified plaque detected by OCT‐contained lipid pools and/or necrotic cores by histology evaluation. Therefore, it is plausible that the surface of calcium may be harder (because of older or matured calcium deposits) than the center of the OCT‐identified calcium and hence surface modification of calcium by OA was effective.…”

Section: Discussionmentioning

confidence: 99%

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Effect of orbital atherectomy in calcified coronary artery lesions as assessed by optical coherence tomography

Yamamoto

Maehara

Kim

et al. 2018

Cathet Cardio Intervent

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Objectives We sought to assess plaque modification and stent expansion following orbital atherectomy (OA) for calcified lesions using optical coherence tomography (OCT). Background The efficacy of OA for treating calcified lesions is not well studied, especially using intravascular imaging in vivo. Methods OCT was performed preprocedure, post‐OA, and post‐stent (n = 58). Calcium modification after OA was defined as a round, concave, polished calcium surface. Calcium fracture was complete discontinuity of calcium. Results Comparing pre‐ vs post‐OA OCT (n = 29), calcium area was significantly decreased post‐OA (from 3.4 mm2 [2.4–4.7] to 2.9 mm2 [1.9–3.9], P < 0.001). Poststent percent calcium fracture (calcium fracture length/calcium length) correlated with post‐OA percent calcium modification (calcium modification length/calcium length) (r = 0.31, P = 0.01). Among 75 calcium fractures in 35 lesions, maximum calcium thickness at the fracture site was greater with vs without calcium modification (0.58 mm [0.50–0.66] vs 0.45 mm [0.38–0.52], P = 0.003). Final optimal stent expansion, defined as minimum stent area ≥6.1 mm2 or stent expansion ≥90% (medians of this cohort) at the maximum calcium angle site, was observed in 41 lesions. Larger post‐OA lumen area (odds ratio 2.64; 95% CI 1.21–5.76; P = 0.02) and the presence of calcium fracture (odds ratio 6.77; 95% CI 1.25–36.6; P = 0.03) were independent predictors for optimal stent expansion. Conclusions Calcium modification by OA facilitates poststent calcium fracture even in thick calcium. Greater calcium modification correlated with greater calcium fracture, in turn resulting in better stent expansion.

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Section: Discussionsupporting

confidence: 57%

Section: Discussionmentioning

confidence: 99%

Effect of orbital atherectomy in calcified coronary artery lesions as assessed by optical coherence tomography

Yamamoto

Maehara

Kim

et al. 2018

Cathet Cardio Intervent

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“…In addition, OFDI findings suggested calcification on the partition walls. Precise recognition of calcified plaque morphology by OFDI may serve to determine the treatment strategy for patients with athero-sclerotic coronary disease [8]. However, previous reports have not revealed the relationship between RA and calcified nodules.…”

Section: Discussionmentioning

confidence: 99%

Rotational Atherectomy for Ablation of Multiple Channel Structure Observed by Optical Frequency Domain Imaging

et al. 2019

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Patient: Male, 71Final Diagnosis: Silent myocardial infarctionSymptoms: DynpneaMedication: —Clinical Procedure: —Specialty: CardiologyObjective:Unusual or unexpected effect of treatmentBackground:Previous case reports have shown that regardless of the etiology, multiple channel structures can be treated successfully by routine percutaneous coronary intervention. However, there are no general recommendations for intervention because multiple channel structures are complex and rarely diagnosed.Case Report:A 71-year-old male was admitted to our hospital due to bronchial pneumonia. After admission, the patient experienced acute decompensated heart failure. Coronary angiogram revealed 3 diseased vessels with heavy calcification. Although the patient’s syntax score was high, we performed percutaneous coronary intervention (PCI) on each vessel based on his request and in consideration of his dementia. After PCI for the left circumflex and descending arteries, we performed PCI for the right coronary artery (RCA) using optical frequency domain imaging (OFDI). A multiple channel structure and calcified nodule were observed by OFDI. We performed rotational atherectomy (RA) on the RCA, and the 2 structures were ablated. After RA, we dilated the lesions with a scoring balloon and deployed a drug-eluting stent.Conclusions:RA was effective in ablating partition walls of the multiple channel structure observed using OFDI.

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“…Fourth, OCT may not fully visualize the deep calcium in the setting of superficial plaque attenuation due to its limited depth of penetration. In addition, strong attenuation due to a lipid-rich component within or adjacent to the calcified area 36 or a thick calcification may make the outer SC) based on OCT findings. These authors reported that the prevalence of CN, CP, and SC was 25.5%, 7.1%, and 67.4%, 11 respectively, whereas in the present study of both ACS and stable coronary artery disease the rates were 9.9%, 26.8%, and 63.3%, respectively.…”

Section: Study Limitationsmentioning

confidence: 99%

Prognostic Impact of Calcified Plaque Morphology After Drug Eluting Stent Implantation　― An Optical Coherence Tomography Study ―

Iwai

Watanabe

Okamura

et al. 2021

Circ J

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Background: Optical coherence tomography (OCT) has the potential to characterize the detailed morphology of calcified coronary plaques. This study examined the prognostic impact of calcified plaque morphology in patients with coronary artery calcification (CAC) who underwent newer-generation drug-eluting stent (DES) implantation. Methods and Results:In all, 251 patients with moderate to severe CAC who underwent OCT-guided DES implantation were reviewed retrospectively and divided into 3 groups according to OCT findings of the target lesion: 25 patients (10.0%) with calcified nodules (CN), 69 patients (27.5%) with calcified protrusion (CP) without CN, and 157 patients (62.5%) with superficial calcific sheet (SC) without CN and CP. The primary endpoint was major adverse cardiac events (MACE), defined as a composite of cardiac death, myocardial infarction, and target lesion revascularization (TLR). Kaplan-Meier survival analysis revealed that, among the 3 groups, the rates of MACE-free survival (log-rank test, P=0.0117), myocardial infarction (log-rank test, P=0.0103), and TLR (log-rank test, P=0.0455) were significantly worse in patients with CN. Multivariate Cox proportional hazards analysis demonstrated that CN was an independent predictor of MACE (hazard ratio 4.41; 95% confidence interval 1.63-10.8; P=0.0047). Conclusions:Target lesion CN was associated with higher cardiac event rates in patients who underwent newer-generation DES implantation for lesions with moderate to severe CAC.

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Evaluation of coronary arterial calcification – Ex-vivo assessment by optical frequency domain imaging

Cited by 28 publications

References 37 publications

Effect of orbital atherectomy in calcified coronary artery lesions as assessed by optical coherence tomography

Effect of orbital atherectomy in calcified coronary artery lesions as assessed by optical coherence tomography

Rotational Atherectomy for Ablation of Multiple Channel Structure Observed by Optical Frequency Domain Imaging

Prognostic Impact of Calcified Plaque Morphology After Drug Eluting Stent Implantation　― An Optical Coherence Tomography Study ―

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Evaluation of coronary arterial calcification – Ex-vivo assessment by optical frequency domain imaging

Cited by 28 publications

References 37 publications

Effect of orbital atherectomy in calcified coronary artery lesions as assessed by optical coherence tomography

Effect of orbital atherectomy in calcified coronary artery lesions as assessed by optical coherence tomography

Rotational Atherectomy for Ablation of Multiple Channel Structure Observed by Optical Frequency Domain Imaging

Prognostic Impact of Calcified Plaque Morphology After Drug Eluting Stent Implantation ― An Optical Coherence Tomography Study ―

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Prognostic Impact of Calcified Plaque Morphology After Drug Eluting Stent Implantation　― An Optical Coherence Tomography Study ―