Serial 3-Vessel Optical Coherence Tomography and Intravascular Ultrasound Analysis of Changing Morphologies Associated With Lesion Progression in Patients With Stable Angina Pectoris

Abstract

Lesion progression was categorized to distinct OCT morphologies that were related to changes in plaque mass or vessel remodeling.

Prognostic impact of healed coronary plaque in non-culprit lesions assessed by optical coherence tomography

“…Mann and Davies [1] investigated 256 plaques in 31 men ages 51-69 years dying suddenly of ischemic heart disease and reported that the prevalence of a prior healed disruption was 17.3% (32/185) in plaques with a diameter stenosis of < 50%. A serial 3-vessel OCT study to investigate the association of plaque morphology and lesion progression showed that the lesion-level prevalence of HP was 14.2% (18/ 127) in NCLs of stable patients [14], consistent with 17.8% in the current cohort (129/726).…”

“…NCLs were considered separate if there was a ≥5 mm-long normal segment between them. HP was defined as a heterogeneous signal-rich layer of different optical intensity located close to the luminal surface with clear demarcation from the underlying plaque [5,6,14] (Fig. 1A).…”

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

“…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.…”

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

“…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). Despite the importance of assessing the healing process of coronary thrombus, the conventional OCT intensity image provides limited insight into the process of thrombus organization.…”

“…However, the majority of TCFAs identified by OCT (10)(11)(12) or virtual-histology IVUS (13)(14)(15) do not cause any acute events, calling into question the established structural criteria of the "vulnerable plaque" (5,16,17). Plaque composition has been identified as an additional critical factor of a lesion's susceptibility to precipitate ACS (4,14,(18)(19)(20).…”