In vivo optical coherence tomography imaging and histopathology of healed coronary plaques

Shimokado, Aiko; Matsuo, Yoshiki; Kubo, Takashi; Nishiguchi, Tsuyoshi; Taruya, Akira; Teraguchi, Ikuko; Shiono, Yasutsugu; Orii, Makoto; Tanimoto, Takashi; Yamano, Takashi; Ino, Yasushi; Hozumi, Takeshi; Tanaka, Atsushi; Muragaki, Yasuteru; Akasaka, Takashi

doi:10.1016/j.atherosclerosis.2018.05.025

Cited by 97 publications

(84 citation statements)

References 23 publications

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“…In OCT imaging, healed plaques appears to have distinct layers of different optical characteristics. [10][11][12] Furthermore, a new directional coronary atherectomy (DCA) device has recently been launched in Japan, which enables intentional excising of coronary atherosclerotic lesions, and these samples can be subjected to histopathological examination. C oronary atherosclerosis begins with the accumulation of lipid within the arterial wall and then follows a histopathological process that has been well classified by the Expert Committee of the American Heart Association.…”

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confidence: 99%

Prevalence and Clinical Significance of Layered Plaque in Patients With Stable Angina Pectoris　― Evaluation With Histopathology and Optical Coherence Tomography ―

Okamoto

Kume

Yamada

et al. 2019

Circ J

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Background: Healed plaques are identified as a layered pattern with optical coherence tomography (OCT) imaging, but the exact relationship between healed plaques and the development of significant coronary stenosis in stable angina pectoris (SAP) is not fully understood. Methods and Results: A retrospective clinincal study investigated the OCT characteristics of culprit lesions of SAP patients (n=205), and a prospective study examined the histopathological characteristics of layered plaque in directional coronary atherectomy (DCA) samples (42 samples from 18 SAP patients). In the retrospective study, layered plaque was observed in 36.6% of the SAP culprit lesions. Compared with patients with non-layered plaque, male sex and smoking were more frequent, and HbA1c level was significantly higher in the patients with layered plaque (81.3% vs. 65.9%, P<0.05; 62.7% vs. 41.8%, P<0.05; 6.6±1.3% vs. 6.2±1.0%, P<0.05, respectively). Furthermore, layered plaque was accompanied by higher plaque vulnerability and smaller minimal lumen area. In the histopathological study, the layered plaques had a significantly higher rate of intramural thrombus and macrophages infiltration than non-layered plaques (75.0% vs. 14.3%, P<0.05; 75.0% vs. 38.1%, P<0.05, respectively). Conclusions: Healed plaque containing intramural thrombus is identified as layered plaque by OCT, and was frequently observed, even in SAP patients. Intramural thrombus might play an important role in the development of coronary plaque with a high degree of stenosis in SAP patients.

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confidence: 99%

Prevalence and Clinical Significance of Layered Plaque in Patients With Stable Angina Pectoris　― Evaluation With Histopathology and Optical Coherence Tomography ―

Okamoto

Kume

Yamada

et al. 2019

Circ J

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“…Subsequent thrombus formation and organization, in which the intimal microvasculature plays a pivotal role, are key to understanding the mechanisms of successful or failed vascular healing (24). In a recent ex vivo study investigating the accuracy of OCT for diagnosing healed ruptured plaques, Shimokado et al proposed the presence of layered structures in the conventional OCT intensity signal as a predictor of histologically determined healed ruptures of coronary plaques (75). Furthermore, clinical studies have demonstrated that layered structure in superficial plaques identified by OCT are associated with plaque vulnerability or rapid progression of coronary artery stenosis (10,76), although there remains some controversy and another study found similar features to indicate enhanced plaque stability (23).…”

Section: Polarization Signatures Of Acute and Organizing Thrombusmentioning

confidence: 99%

Intravascular Polarimetry: Clinical Translation and Future Applications of Catheter-Based Polarization Sensitive Optical Frequency Domain Imaging

Otsuka

Villiger

Nadkarni

et al. 2020

Front. Cardiovasc. Med.

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Optical coherence tomography (OCT) and optical frequency domain imaging (OFDI) visualize the coronary artery wall and plaque morphology in great detail. The advent of these high-resolution intracoronary imaging modalities has propelled our understanding of coronary atherosclerosis and provided enhanced guidance for percutaneous coronary intervention. Yet, the lack of contrast between distinct tissue types and plaque compositions impedes further elucidation of the complex mechanisms that contribute to acute coronary syndrome (ACS) and hinders the prospective identification of plaques susceptible to rupture. Intravascular polarimetry with polarization-sensitive OFDI measures polarization properties of the coronary arterial wall using conventional intravascular imaging catheters. The quantitative polarization metrics display notable image contrast between several relevant coronary plaque microstructures that are difficult to identify with conventional OCT and OFDI. Tissues rich in collagen and smooth muscle cells exhibit birefringence, while lipid and macrophages cause depolarization. In this review, we describe the basic principles of intravascular polarimetry, discuss the interpretation of the polarization signatures, and outline promising avenues for future research and clinical implications.

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“…This phenotype is believed to be the result of repair processes of ruptured or eroded plaques [ 30 ]. Identification of these lesions with OCT has recently been validated against histology and has gained considerable attention in the last year [ 31 ]. In an observational cohort study of 105 patients who had undergone coronary angiography with OCT imaging of non-culprit lesions, patients were divided into two groups based on the two extremes of the clinical spectrum of CAD [ 32 ].…”

Section: Intracoronary Optical Coherence Tomography For Diagnosis Andmentioning

confidence: 99%

Recent developments in diagnosis and risk stratification of non-ST-elevation acute coronary syndrome

et al. 2020

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In vivo optical coherence tomography imaging and histopathology of healed coronary plaques

Cited by 97 publications

References 23 publications

Prevalence and Clinical Significance of Layered Plaque in Patients With Stable Angina Pectoris　― Evaluation With Histopathology and Optical Coherence Tomography ―

Prevalence and Clinical Significance of Layered Plaque in Patients With Stable Angina Pectoris　― Evaluation With Histopathology and Optical Coherence Tomography ―

Intravascular Polarimetry: Clinical Translation and Future Applications of Catheter-Based Polarization Sensitive Optical Frequency Domain Imaging

Recent developments in diagnosis and risk stratification of non-ST-elevation acute coronary syndrome

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In vivo optical coherence tomography imaging and histopathology of healed coronary plaques

Cited by 97 publications

References 23 publications

Prevalence and Clinical Significance of Layered Plaque in Patients With Stable Angina Pectoris ― Evaluation With Histopathology and Optical Coherence Tomography ―

Prevalence and Clinical Significance of Layered Plaque in Patients With Stable Angina Pectoris ― Evaluation With Histopathology and Optical Coherence Tomography ―

Intravascular Polarimetry: Clinical Translation and Future Applications of Catheter-Based Polarization Sensitive Optical Frequency Domain Imaging

Recent developments in diagnosis and risk stratification of non-ST-elevation acute coronary syndrome

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Product

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Prevalence and Clinical Significance of Layered Plaque in Patients With Stable Angina Pectoris　― Evaluation With Histopathology and Optical Coherence Tomography ―

Prevalence and Clinical Significance of Layered Plaque in Patients With Stable Angina Pectoris　― Evaluation With Histopathology and Optical Coherence Tomography ―