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FUSION OF INTRAVASCULAR ULTRASOUND AND OPTICAL COHERENCE TOMOGRAPHY IMAGINGS TO COMPREHENSIVELY ASSESS CALCIFIED PLAQUE DEVELOPMENT IN- AND OUT-SCAFFOLD SEGMENTS AFTER BIORESORBABLE ABSORB SCAFFOLD IMPLANTATION
270 JACC April 5, 2016 Volume 67, Issue 13
ACC.i2 Interventional Cardiology FUSION OF INTRAVASCULAR ULTRASOUND AND OPTICAL COHERENCE TOMOGRAPHY IMAGINGS TO COMPREHENSIVELY ASSESS CALCIFIED PLAQUE DEVELOPMENT IN- AND OUT-SCAFFOLD SEGMENTS AFTER BIORESORBABLE ABSORB SCAFFOLD IMPLANTATION Poster Contributions Poster Area, South Hall A1 Sunday, April 03, 2016, 9:45 a.m.-10:30 a.m. Session Title: ACC.i2 Interventional Cardiology: IVUS and Intravascular Physiology Abstract Category: 9. ACC.i2 Interventional Cardiology: IVUS and Intravascular Physiology Presentation Number: 1177-187 Authors: Yaping Zeng, Hiroki Tateishi, Erhan Tenekecioglu, Rafael Cavalcante, Pannipa Suwannsom, Yohei Sotomi, Felipe Albuquerque, Yoshinobu Onuma, Patrick Serruys, Department of Cardiology, Thorax Centre, Erasmus Medical Center, Rotterdam, The Netherlands Background: Sole IVUS or OCT has limitation and individual strength in assessing plaque composition. Their fusion may better characterize growth of calcified plaque. The objective of the present study is to assess the calcium growth with fused OCT and IVUS images in- and out-scaffold segments from baseline to 5 year follow-up in patients treated with the Bioresorbable Absorb Scaffold.
Methods: Fifteen patients underwent serial OCT and IVUS examinations at baseline and 5-year follow-up. Side branch, vein, calcium, radiopaque markers were used to match OCT and IVUS images. Serial analysis of tissue composition, as well as calcium area, angle and length were derived from fused images. Results: Fifteen patients, 16 lesions, 72 matched cross sections (100%) were analyzed. Forty (55.6%) in- and out-scaffold cross sections showed no calcium at baseline and follow-up; Nineteen (26.4%) cross sections showed calcium progression: calcium area, angle, length increased to a similar extent in- and out-scaffold segments; The minimal intima thickness of calcium in-scaffold (148.09 ± 193.83 µm) tended to be thicker than out-scaffold segment (67.66 ± 113.62 µm) (p=0.075). Thirteen cross sections (18.1%) in- and out-scaffold developed de novo calcified plaques; the major tissue precursors of calcified plaque were: necrotic core in 10 cross sections (76.9%), fibrofatty in 1 cross section (7.7%), necrotic core and fibrofatty in 2 cross sections (15.4%) respectively.
Conclusions: Fusion of OCT and IVUS provides a unique methodology to assess the calcium appearance and progression. Necrotic core is the most frequent precursor of calcified plaque. The minimal intima thickness on top of calcium is thicker in-scaffold than out-scaffold segments, due to integration of the polymeric struts into the vessel wall.
ACC.i2 Interventional Cardiology FUSION OF INTRAVASCULAR ULTRASOUND AND OPTICAL COHERENCE TOMOGRAPHY IMAGINGS TO COMPREHENSIVELY ASSESS CALCIFIED PLAQUE DEVELOPMENT IN- AND OUT-SCAFFOLD SEGMENTS AFTER BIORESORBABLE ABSORB SCAFFOLD IMPLANTATION Poster Contributions Poster Area, South Hall A1 Sunday, April 03, 2016, 9:45 a.m.-10:30 a.m. Session Title: ACC.i2 Interventional Cardiology: IVUS and Intravascular Physiology Abstract Category: 9. ACC.i2 Interventional Cardiology: IVUS and Intravascular Physiology Presentation Number: 1177-187 Authors: Yaping Zeng, Hiroki Tateishi, Erhan Tenekecioglu, Rafael Cavalcante, Pannipa Suwannsom, Yohei Sotomi, Felipe Albuquerque, Yoshinobu Onuma, Patrick Serruys, Department of Cardiology, Thorax Centre, Erasmus Medical Center, Rotterdam, The Netherlands Background: Sole IVUS or OCT has limitation and individual strength in assessing plaque composition. Their fusion may better characterize growth of calcified plaque. The objective of the present study is to assess the calcium growth with fused OCT and IVUS images in- and out-scaffold segments from baseline to 5 year follow-up in patients treated with the Bioresorbable Absorb Scaffold.
Methods: Fifteen patients underwent serial OCT and IVUS examinations at baseline and 5-year follow-up. Side branch, vein, calcium, radiopaque markers were used to match OCT and IVUS images. Serial analysis of tissue composition, as well as calcium area, angle and length were derived from fused images. Results: Fifteen patients, 16 lesions, 72 matched cross sections (100%) were analyzed. Forty (55.6%) in- and out-scaffold cross sections showed no calcium at baseline and follow-up; Nineteen (26.4%) cross sections showed calcium progression: calcium area, angle, length increased to a similar extent in- and out-scaffold segments; The minimal intima thickness of calcium in-scaffold (148.09 ± 193.83 µm) tended to be thicker than out-scaffold segment (67.66 ± 113.62 µm) (p=0.075). Thirteen cross sections (18.1%) in- and out-scaffold developed de novo calcified plaques; the major tissue precursors of calcified plaque were: necrotic core in 10 cross sections (76.9%), fibrofatty in 1 cross section (7.7%), necrotic core and fibrofatty in 2 cross sections (15.4%) respectively.
Conclusions: Fusion of OCT and IVUS provides a unique methodology to assess the calcium appearance and progression. Necrotic core is the most frequent precursor of calcified plaque. The minimal intima thickness on top of calcium is thicker in-scaffold than out-scaffold segments, due to integration of the polymeric struts into the vessel wall.