Thin-cap fibroatheroma and microchannel findings in optical coherence tomography correlate with subsequent progression of coronary atheromatous plaques

Uemura, Shiro; Ishigami, Kousei; Soeda, Tsunenari; Okayama, Satoshi; Sung, Ji Hee; Nakagawa, Hitoshi; Somekawa, Satoshi; Takeda, Yukiji; Kawata, Hiroyuki; Horii, Manabu; Saito, Yoshihiko

doi:10.1093/eurheartj/ehr284

Cited by 232 publications

(135 citation statements)

References 28 publications

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“…A prospective study of the characteristics of non-culprit lesions in 53 patients with coronary artery disease undergoing PCI showed that TCFA (as assessed by OCT) and the presence of micro-channels had a significant correlation with plaque progression (defined as >0.4 mm increase in minimal luminal diameter) at a seven-month follow-up. 29 …”

Section: Plaque Characterisationmentioning

confidence: 99%

Intravascular Ultrasound Versus Optical Coherence Tomography for Coronary Artery Imaging – Apples and Oranges?

Rathod¹,

Hamshere²,

Jones³

et al. 2015

Interventional Cardiology Review

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Coronary angiography has been the gold standard technique for evaluating coronary arterial disease for the past 50 years. Increasingly, however, realisation of the limitations of coronary angiography, mainly the inability to supply information regarding the coronary wall, has prompted the design and development of adjunctive technologies to better evaluate not just luminal disease but also the burden and character of atherosclerotic plaque within the vessel. The development of intracoronary imaging modalities, namely intravascular ultrasound (IVUS) and optical coherence tomography (OCT), has progressed quickly and these technologies now have established roles in the diagnosis and treatment of coronary artery disease. In general, intracoronary devices that can assess the coronary endothelium use either acoustic or optical signals that are received by a coronary catheter (IVUS uses ultrasound, OCT uses near-infrared light).This review addresses these two widely used intracoronary imaging techniques, looking at their clinical applications, recent evidence for their use and describes new developments in the field. Intravascular UltrasoundIn the last 25 years IVUS has been established as the most commonly used intracoronary imaging device. An IVUS system consists of a flexible monorail catheter with an ultrasound transducer at its tip that emits ultrasound waves in the 10-40 MHz range and an electronics console to reconstruct the image (see Figure 1).1 After reflection from tissue, part of the ultrasound energy returns to the transducer and is converted into the image.There are two types of IVUS transducers for clinical use: the mechanical rotating transducer and the electronically switched phased array system.The mechanical transducer uses a single crystal on a rotational device, which visualises the entire vessel in cross-section providing better image quality (compared with phased array technology) of 100-150 μm.2 The main disadvantage of mechanical transducers is the central drive shaft that decreases flexibility and prevents the concurrent use of a central guidewire.3 However, newer rotational IVUS catheters have developed a monorail system that allows for the presence of a central guidewire.Phased array catheters use multiple transducer elements, which are mounted along the circumference of the catheter tip. Each element sends and receives ultrasounds from a sector and multiple sectors are gathered to produce a cross-sectional image of the artery. However, they are disadvantaged by a technically complex set-up, requiring detailed programming; 3 but some of the newer catheters are easier to set up.Intracoronary imaging of coronary vessels by IVUS is performed using standard coronary interventional techniques and equipment (guiding catheter and 0.014 inch angioplasty guidewire) for catheter delivery along the guidewire beyond the target lesion/area of interest. Intravenous heparin and glyceryl trinitrate (nitroglycerin) are routinely administered before imaging. The IVUS catheter is then drawn back across the tar...

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Section: Plaque Characterisationmentioning

confidence: 99%

Intravascular Ultrasound Versus Optical Coherence Tomography for Coronary Artery Imaging – Apples and Oranges?

Rathod¹,

Hamshere²,

Jones³

et al. 2015

Interventional Cardiology Review

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show abstract

“…Previous studies using invasive techniques [34][35][36][37] have identified high-risk features such as thin-cap, low residual lumen area, and spotty calcification as the hallmark of high-risk plaques. These high-risk plaques identified by either IVUS or OCT were also associated with adverse clinical outcomes.…”

Section: Discussionmentioning

confidence: 99%

Rationale and design of the Progression of AtheRosclerotic PlAque DetermIned by Computed TomoGraphic Angiography IMaging (PARADIGM) registry: A comprehensive exploration of plaque progression and its impact on clinical outcomes from a multicenter serial coronary computed tomographic angiography study

Lee

Chang

Rizvi

et al. 2016

American Heart Journal

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“…Lesions that progressed more often had vessel wall discontinuities (61.5% vs. 8.9%, P < 0.01), neo-vessels (76.9% vs. 14.3%, P < 0.01), lipid-rich plaques (100% vs. 60.7%, P = 0.02), TCFA phenotype (76.9% vs. 14.3%, P < 0.01), macrophages accumulations (61.5% vs. 14.3%, P < 0.01), and intraluminal thrombi (30.8% vs. 1.8%, P < 0.01) compared to those that remained unchanged. This analysis demonstrated for the first time the clinical implications of plaque micro-features, but it included a small number of patients that did not allow assessment of their additive value in predicting high-risk vulnerable plaques [49].…”

Section: Optical Coherence Tomographymentioning

confidence: 99%

Invasive or non-invasive imaging for detecting high-risk coronary lesions?

Patel

Tarkin

Serruys

et al. 2017

Expert Review of Cardiovascular Therapy

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Introduction: Advances in our understanding about atherosclerotic evolution have enabled us to identify specific plaque characteristics that are associated with coronary plaque vulnerability and cardiovascular events. With constant improvements in signal and image processing an arsenal of invasive and non-invasive imaging modalities have been developed that are capable of identifying these features allowing in vivo assessment of plaque vulnerability. Areas covered: This review article presents the available and emerging imaging modalities introduced to assess plaque morphology and biology, describes the evidence from the first large scale studies that evaluated the efficacy of invasive and non-invasive imaging in detecting lesions that are likely to progress and cause cardiovascular events and discusses the potential implications of the in vivo assessment of coronary artery pathology in the clinical setting. Expert commentary: Invasive imaging, with its high resolution, and in particular hybrid intravascular imaging appears as the ideal approach to study the mechanisms regulating atherosclerotic disease progression; whereas non-invasive imaging is expected to enable complete assessment of coronary tree pathology, detection of high-risk lesions, more accurate risk stratification and thus to allow a personalized treatment of vulnerable patients. ARTICLE HISTORY

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Thin-cap fibroatheroma and microchannel findings in optical coherence tomography correlate with subsequent progression of coronary atheromatous plaques

Abstract: Optical coherence tomography-based complex characteristics of TCFA and microchannel were the potential predictors of subsequent progression of NSCPs in patients with CAD.

Cited by 232 publications

References 28 publications

Intravascular Ultrasound Versus Optical Coherence Tomography for Coronary Artery Imaging – Apples and Oranges?

Intravascular Ultrasound Versus Optical Coherence Tomography for Coronary Artery Imaging – Apples and Oranges?

Invasive or non-invasive imaging for detecting high-risk coronary lesions?

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