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血管内超声指导

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Novel predictors of late lumen enlargement in distal reference segments after successful recanalization of coronary chronic total occlusion A Combined Optical Coherence Tomography and Intravascular Ultrasound Study on Plaque Rupture, Plaque Erosion, and Calcified Nodule in Patients With ST-Segment Elevation Myocardial Infarction: Incidence, Morphologic Characteristics, and Outcomes After Percutaneous Coronary Intervention Usefulness of intravascular ultrasound guidance in percutaneous coronary intervention with second-generation drug-eluting stents for chronic total occlusions (from the Multicenter Korean-Chronic Total Occlusion Registry) Intravascular Ultrasound Assessment of In-Stent Restenosis in Saphenous Vein Grafts Intravascular ultrasound-guided drug-eluting stent implantation: An updated meta-analysis of randomized control trials and observational studies Intravascular Ultrasound Guidance Is Associated With Better Outcome in Patients Undergoing Unprotected Left Main Coronary Artery Stenting Compared With Angiography Guidance Alone Impact of final stent dimensions on long-term results following sirolimus-eluting stent implantation: serial intravascular ultrasound analysis from the sirius trial Is intravascular ultrasound beneficial for percutaneous coronary intervention of bifurcation lesions? Evidence from a 4,314-patient registry Relation between baseline plaque features and subsequent coronary artery remodeling determined by optical coherence tomography and intravascular ultrasound Utility of intravascular ultrasound guidance in patients undergoing percutaneous coronary intervention for type C lesions

Clinical Trial2013 Mar;6(3):228-36.

JOURNAL:JACC Cardiovasc Interv. Article Link

Optical coherence tomography versus intravascular ultrasound to evaluate coronary artery disease and percutaneous coronary intervention

Bezerra HG, Attizzani GF, Sirbu V et al. Keywords: IVUS; OCT; PCI

ABSTRACT


OBJECTIVESWe compared intravascular ultrasound (IVUS) and 2 different generations of optical coherence tomography (OCT)-time-domain OCT (TD-OCT) and frequency-domain OCT (FD-OCT)-for the assessment of coronary disease and percutaneous coronary intervention (PCI) using stents.


BACKGROUND - OCT is a promising light-based intravascular imaging modality with higher resolution than IVUS. However, the paucity of data on OCT image quantification has limited its application in clinical practice.

METHODS - A total of 227 matched OCT and IVUS pull backs were studied. One hundred FD-OCT and IVUS pull backs in nonstented (n = 56) and stented (n = 44) vessels were compared. Additionally, 127 matched TD-OCT and IVUS images were compared in stented vessels.

RESULTS - FD-OCT depicted more severe native coronary disease than IVUS; minimal lumen area (MLA) was 2.33 ± 1.56 mm(2) versus 3.32 ± 1.92 mm(2), respectively (p < 0.001). Reference vessel dimensions were equivalent between FD-OCT and IVUS in both native and stented coronaries, but TD-OCT detected smaller reference lumen size compared with IVUS. Immediately post-PCI, in-stent MLAs were similar between FD-OCT and IVUS, but at follow-up, both FD-OCT and TD-OCT detected smaller MLAs than did IVUS, likely due to better detection of neointimal hyperplasia (NIH). Post-PCI malapposition and tissue prolapse were more frequently identified by FD-OCT.

CONCLUSIONS - FD-OCT generates similar reference lumen dimensions but higher degrees of disease severity and NIH, as well as better detection of malapposition and tissue prolapse compared with IVUS. First-generation TD-OCT was associated with smaller reference vessel dimensions compared with IVUS.

Copyright © 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.