Serial Assessment of Tissue Precursors and Progression of Coronary Calcification Analyzed by Fusion of IVUS and OCT: 5-Year Follow-Up of Scaffolded and Nonscaffolded Arteries

Yaping Zeng, Hiroki Tateishi, Rafael Cavalcante, Erhan Tenekecioglu, Pannipa Suwannasom, Yohei Sotomi, Carlos Collet, Shaoping Nie, Hans Jonker, Jouke Dijkstra, Maria D Radu, Lorenz Räber, Dougal R McClean, Robert-Jan van Geuns, Evald H Christiansen, Therese Fahrni, Jacques Koolen, Yoshinobu Onuma, Nico Bruining, Patrick W Serruys

    30 Citationer (Scopus)

    Abstract

    OBJECTIVES: The aim of this study was to assess calcium growth with fused grayscale intravascular ultrasound (IVUS), IVUS-virtual histology, and optical coherence tomography (OCT) from baseline to 5-year follow-up in patients treated with bioresorbable vascular scaffolds.

    BACKGROUND: IVUS and OCT have individual strengths in assessing plaque composition and volume. Fusion of images obtained using these methods could potentially aid in coronary plaque assessment.

    METHODS: Anatomic landmarks and endoluminal radiopaque markers were used to fuse OCT and IVUS images and match baseline and follow-up.

    RESULTS: Seventy-two IVUS-virtual histology and OCT paired matched cross-sectional in- and out-scaffold segments were fused at baseline and follow-up. In total, 46 calcified plaques at follow-up were detected using the fusion method (33 in-scaffold, 13 out-scaffold), showing either calcium progression (52.2%) or de novo calcifications (47.8%). On OCT, calcification volume increased from baseline to follow-up by 2.3 ± 2.4 mm3 (p = 0.001). The baseline virtual histologic tissue precursors of dense calcium at follow-up were necrotic core in 73.9% and fibrous or fibrofatty plaque in 10.9%. In 15.2%, calcium was already present at baseline. Precursors on OCT were lipid pool in 71.2%, fibrous plaque in 4.3%, and fibrocalcific plaque in 23.9%.

    CONCLUSIONS: The use of OCT and IVUS fusion imaging shows similar calcium growth in- and out-scaffold segments. Necrotic core is the most frequent precursor of calcification. The scaffold resorption process creates a tissue layer that re-caps the calcified plaques. (Absorb Clinical Investigation, Cohort B [ABSORB B]; NCT00856856).

    OriginalsprogEngelsk
    TidsskriftJACC. Cardiovascular imaging
    Vol/bind10
    Udgave nummer10 Pt A
    Sider (fra-til)1151-1161
    Antal sider11
    ISSN1936-878X
    DOI
    StatusUdgivet - okt. 2017

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