AS-056 Accuracy of Frequency-Domain Optical Coherence Tomography for Quantitative Measurements: Comparison With Intravascular Ultrasound

Wednesday, April 27, 2011

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Invasive Imaging: IVUS, OCT, Spectroscopy, and Other Imaging I

A B S T R A C T S

Wednesday, April 27, 2011 4:00 PM ⬃ 5:00 PM (Abstracts nos. AS-056, AS-057, AS-058, AS-059, AS-060)

Imaging II Wednesday, April 27, 2011 5:00 PM ⬃ 6:00 PM (Abstracts nos. AS-061, AS-062, AS-064, AS-065)

AS-056 Accuracy of Frequency-Domain Optical Coherence Tomography for Quantitative Measurements: Comparison With Intravascular Ultrasound. Kenichi Komukai, Hironori Kitabata, Hiroto Tsujioka, Kohei Ishibashi, Takashi Tanimoto, Nozomi Wada, Yasushi Ino, Hiroko Nakanishi, Keizo Kimura, Kumiko Hirata, Masato Mizukoshi, Toshio Imanishi, Takashi Akasaka. Wakayama Medical University, Wakayama, Japan. Background: Intracoronary frequency-domain optical coherence tomography (FD-OCT) is a novel technology which provides highresolution cross-sectional images of coronary arteries. Despite the need for accuracy data to design longitudinal studies, such information remains unexplored. The aim of the present study was to evaluate the accuracy of FD-OCT analysis of coronary arteries compared with intravascular ultrasound (IVUS) in a clinical setting. Methods: We examined 13 stented lesions using IVUS and FDOCT (C7, LightLab Imaging, Inc., Westford, Massachusetts). FDOCT and IVUS imaging were analyzed by 2 independent observers. Stent length (SL) was measured in the long axis image. Lumen area (LA) and stent area (SA) were measured at every 1mm crosssection. Results: SL, mean LA and mean SA measured by FD-OCT were significantly correlated with those measured by IVUS (r⫽0.98, p⬍0.001; r⫽0.98, p⬍0.001; and r⫽0.98, p⬍0.001, respectively). The absolute difference of SL, mean LA and mean SA between IVUS and FD-OCT were 0.71⫾0.70mm; 0.65⫾0.43mm2; and 0.39⫾0.38mm2. The limits of agreement for SL, mean LA and mean SA were ⫺2.0, 2.0mm; ⫺0.19, 1.49 mm2; and ⫺043, 1.15mm2.

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Conclusion: The FD-OCT showed a good accuracy of intracoronary measurements compared with those of IVUS. Our results emphasize the value of FD-OCT as a tool for the quantitative assessment of coronary stented lesions.

AS-057 The Assessment of Shin’s Method for The Prediction of Creatinine Kinase-MB Elevation after Percutaneous Coronary Intervention: An Intravascular Ultrasound Study. Eun-Seok Shin1, Hector M. Garcia-Garcia2, Scot Garg2, Jongha Park1, Shin-Jae Kim1, Patrick W. Serruys2. 1Ulsan University Hospital, Ulsan, Korea (Republic of); 2Thoraxcenter, Rotterdam, Netherlands. Background: Cardiac enzyme release is common after percutaneous coronary intervention (PCI). At present there is no established relationship between the quantity of necrotic core and dense calcium, as assessed by Shin’s method using intravascular ultrasound virtual histology (VHIVUS), and post-PCI creatinine kinase-MB (CK-MB) elevation. Methods: A total of 112 consecutive patients with unstable angina and a normal pre-PCI CK-MB level were imaged using VH-IVUS. Patients were divided into 2 groups according to the presence (CK-MB group, n ⫽ 27) or absence (non CK-MB group, n ⫽ 85) of a post-PCI CK-MB elevation ⬎ 1.0 the upper limit of normal (3.6 ng/ml). Using Shin’s method contours were drawn around the IVUS catheter (instead of the lumen), and the vessel. Results: Mean area and volume of necrotic core and dense calcium were significantly greater in CK-MB group than in non CK-MB group (1.7 ⫾ 0.9 mm2 vs. 0.9 ⫾ 0.6 mm2, p ⬍ 0.001; 17.2 ⫾ 8.8 mm3 vs. 8.8 ⫾ 5.8 mm3, p ⬍ 0.001, and 0.9 ⫾ 0.6 mm2 vs. 0.4 ⫾ 0.4 mm2, p ⫽ 0.001; 9.1 ⫾ 5.8 mm3 vs. 3.9 ⫾ 3.7 mm3, p ⬍ 0.001, respectively). Percent necrotic core and dense calcium areas calculated by external elastic membrane (EEM) area were significantly greater in CK-MB group than in non CK-MB group (11.9 ⫾ 5.1% vs. 6.6 ⫾ 4.0%, p ⬍ 0.001 and 6.5 ⫾ 4.0% vs. 3.0 ⫾ 2.9%, p ⬍ 0.001, respectively). In the multivariate analysis, dense calcium volume and percent necrotic core to EEM at the most diseased segment were the only independent predictors of post-PCI CK-MB elevation (odds ratio: 1.22; 95% confidence interval: 1.09 to 1.37, p ⬍ 0.001 and odds ratio: 1.26; 95% confidence interval: 1.12 to 1.43, p ⬍ 0.001). Conclusion: Lesions with a greater amount of dense calcium volume and percent necrotic core to EEM, which can be easily identified and quantified on VH-IVUS analyzed using Shin’s method, are responsible for post-PCI CK-MB elevation. With a rapid analyzing time, Shin’s method may increase the identification of high risk lesions likely to induce a post-procedural myocardial injury in the catheterization laboratory facilitating on-line clinical decision making.

AS-058 Atherosclerotic Neointimal Change Could Be One of the Causes of Stent Thrombosis: An Optical Coherence Tomography Study. Yuetsu Kikuta, Hideo Takebayashi, Shigeki Hiramatsu, Kenji Goto, Masahito Taniguchi, Sunao Kodama, Katsumasa Sato, Yasukazu Fujiwara, Shigeki Nishiyama, Seiichi Haruta. Fukuyama Cardiovascular Hospital, Fukuyama, Japan. Background: Little is available on the neointimal characteristics of the lesions with late stent thrombosis (ST) after coronary-artery stenting. Methods: We evaluated 30 consecutive nonostial stent failure lesions in 30 patients (5 ST and 25 restenoses) by optical coherence tomography.

The American Journal of Cardiology姞 APRIL 27–29, 2011 ANGIOPLASTY SUMMIT ABSTRACTS/Oral