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IVUS Guidance

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Prospective application of pre-defined intravascular ultrasound criteria for assessment of intermediate left main coronary artery lesions results from the multicenter LITRO study Clinical impact of intravascular ultrasound guidance in drug-eluting stent implantation for unprotected left main coronary disease: pooled analysis at the patient-level of 4 registries Intravascular ultrasound findings of early stent thrombosis after primary percutaneous intervention in acute myocardial infarction: a Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction (HORIZONS-AMI) substudy Imaging- and physiology-guided percutaneous coronary intervention without contrast administration in advanced renal failure: a feasibility, safety, and outcome study Coronary artery imaging with intravascular high-frequency ultrasound Mechanisms of in-stent restenosis after drug-eluting stent implantation: intravascular ultrasound analysis Comparison of one-year clinical outcomes between intravascular ultrasound-guided versus angiography-guided implantation of drug-eluting stents for left main lesions: a single-center analysis of a 1,016-patient cohort Stent underexpansion and residual reference segment stenosis are related to stent thrombosis after sirolimus-eluting stent implantation: an intravascular ultrasound study Intravascular Ultrasound Guidance Reduces Cardiac Death and Coronary Revascularization in Patients Undergoing Drug-Eluting Stent Implantation: Results From a Meta-Analysis of 9 Randomized Trials and 4724 Patients The Role of Vascular Imaging in Guiding Routine Percutaneous Coronary Interventions: A Meta-Analysis of Bare Metal Stent and Drug-Eluting Stent Trials

Clinical Trial2011 Apr;6(9):1037-45.

JOURNAL:EuroIntervention. Article Link

First-in-man evaluation of intravascular optical frequency domain imaging (OFDI) of Terumo: a comparison with intravascular ultrasound and quantitative coronary angiography

Okamura T, Onuma Y, Garcia-Garcia HM et al. Keywords: IVUS; stents; OCT; coronary imaging; optical frequency domain imaging

ABSTRACT


AIMS The objective of this study is to evaluate the feasibility and safety of imaging human coronary arteries in vivo by optical frequency domain imaging (OFDI) in comparison to intravascular ultrasound (IVUS). OFDI has been recently developed to overcome the limitations of conventional time-domain optical coherence tomography (OCT), namely the need for proximal balloon occlusion. The Terumo-OFDI system is capable of acquiring images with high-speed automated pullback (up to 40 mm/sec) and requires only a short injection (3-4 sec) of small amount of x-ray contrast (9-16 ml).


METHODS AND RESULTS - Nineteen patients who underwent stent implantation were enrolled. IVUS/OFDI were performed before and after stenting. The incidences of any adverse event and angiographic adverse findings were recorded. Lumen area (LA) was measured by IVUS and OFDI at 1 mm intervals in the stented segments (n=19) as well as in the proximal, distal, and to-be-stented segments (n=40). In addition, lumen area in the stented segment was also measured by edge (E-) and video-densitometric (VD-) quantitative coronary angiography (QCA). The OFDI images were obtained without any adverse event related to imaging procedures. Post stenting (n=19), minimal LA (MLA) measured by OFDI (5.84 ± 1.89 mm2) was larger than that of E-QCA (4.16 ± 1.46 mm2, p<0.001) and VD-QCA (4.92 ± 1.55 mm2, p<0.05). It was smaller than IVUS-MLA (6.26 ± 2.01 mm2, N.S.) but the correlation between the two measurements was highly significant (R2=0.82, p<0.001).

CONCLUSIONS - The OFDI imaging is feasible both before and after stenting and has a promising safety profile. The OFDI provided clear high resolution images and robust lumen measurements.