Optical coherence tomography versus intravascular ultrasound for culprit lesion assessment in patients with acute myocardial infarction

2020
journal article
article
3
cris.lastimport.wos2024-04-09T18:48:01Z
dc.abstract.enIntroduction: In patients with acute myocardial infarction (AMI) undergoing primary percutaneous coronary intervention (PCI) the implanted stent may not fully cover the whole intravascular ultrasound (IVUS)-derived thin-cap fibroatheroma (TCFA) related to the culprit lesion (CL). Aim: Whether this phenomenon is more pronounced when optical coherence tomography (OCT) assessment of the CL is performed is not known. Material and methods: Thus, we aimed to assess CLs in 40 patients with AMI treated with PCI, using VH (virtual histology)-IVUS and OCT before and after intervention. The results were blinded to the operator and PCI was done under angiography guidance. Results: Uncovered lipid-rich plaques were identified in the stent reference segments of 23 (57.5%) patients: in 13 (32.5%) of them in the distal reference segment and in 19 (47.5%) of them in the proximal reference segment. In 9 of them (22.5%) lipid plaques were found in both reference segments. In 36 (90%) patients OCT confirmed lipid plaques identified as VH-derived TCFA by VH-IVUS in the reference segments of the stented segment. However, OCT confirmed that only in 2 (5%) patients were uncovered lipid plaques true TCFA as defined by histology. Comparing IVUS and OCT qualitative characteristics of the stented segments OCT detected more thrombus protrusions and proximal and distal stent edge dissections compared to IVUS (92.5 vs. 55%, p = 0.001; 20% vs. 7.5%, p = 0.03 and 25% vs. 5%, p < 0.001, respectively). Conclusions: Due to its superior resolution, OCT identifies TCFA more precisely. OCT more often shows remaining problems related to stent implantation than IVUS after angiographically guided PCI.pl
dc.affiliationWydział Lekarski : Instytut Kardiologiipl
dc.cm.date2021-02-15
dc.cm.id100405
dc.contributor.authorMrevlje, Blazpl
dc.contributor.authorKleczyński, Paweł - 148282 pl
dc.contributor.authorKranjec, Igorpl
dc.contributor.authorJąkała, Jacekpl
dc.contributor.authorNoc, Marcopl
dc.contributor.authorRzeszutko, Łukasz - 354634 pl
dc.contributor.authorDziewierz, Artur - 241962 pl
dc.contributor.authorWizimirski, Marcinpl
dc.contributor.authorDudek, Dariusz - 129271 pl
dc.contributor.authorLegutko, Jacek - 130630 pl
dc.date.accessioned2021-02-15T01:20:46Z
dc.date.available2021-02-15T01:20:46Z
dc.date.issued2020pl
dc.date.openaccess0
dc.description.accesstimew momencie opublikowania
dc.description.number2 (60)pl
dc.description.physical145-152pl
dc.description.points40
dc.description.versionostateczna wersja wydawcy
dc.description.volume16pl
dc.identifier.doi10.5114/aic.2020.96057pl
dc.identifier.eissn1897-4295pl
dc.identifier.issn1734-9338pl
dc.identifier.projectROD UJ / OPpl
dc.identifier.urihttps://ruj.uj.edu.pl/xmlui/handle/item/263739
dc.languageengpl
dc.language.containerengpl
dc.rightsUdzielam licencji. Uznanie autorstwa - Użycie niekomercyjne - Na tych samych warunkach 4.0 Międzynarodowa*
dc.rights.licenceCC-BY-NC-SA
dc.rights.urihttp://creativecommons.org/licenses/by-nc-sa/4.0/legalcode.pl*
dc.share.typeotwarte czasopismo
dc.subject.enpercutaneous coronary interventionpl
dc.subject.enacute myocardial infarctionpl
dc.subject.enoptical coherence tomographypl
dc.subject.enintravascular ultrasoundpl
dc.subject.enthin-cap fibroatheromapl
dc.subject.enculprit lesionpl
dc.subtypeArticlepl
dc.titleOptical coherence tomography versus intravascular ultrasound for culprit lesion assessment in patients with acute myocardial infarctionpl
dc.title.journalPostępy w Kardiologii Interwencyjnejpl
dc.typeJournalArticlepl
dspace.entity.typePublication
cris.lastimport.wos
2024-04-09T18:48:01Z
dc.abstract.enpl
Introduction: In patients with acute myocardial infarction (AMI) undergoing primary percutaneous coronary intervention (PCI) the implanted stent may not fully cover the whole intravascular ultrasound (IVUS)-derived thin-cap fibroatheroma (TCFA) related to the culprit lesion (CL). Aim: Whether this phenomenon is more pronounced when optical coherence tomography (OCT) assessment of the CL is performed is not known. Material and methods: Thus, we aimed to assess CLs in 40 patients with AMI treated with PCI, using VH (virtual histology)-IVUS and OCT before and after intervention. The results were blinded to the operator and PCI was done under angiography guidance. Results: Uncovered lipid-rich plaques were identified in the stent reference segments of 23 (57.5%) patients: in 13 (32.5%) of them in the distal reference segment and in 19 (47.5%) of them in the proximal reference segment. In 9 of them (22.5%) lipid plaques were found in both reference segments. In 36 (90%) patients OCT confirmed lipid plaques identified as VH-derived TCFA by VH-IVUS in the reference segments of the stented segment. However, OCT confirmed that only in 2 (5%) patients were uncovered lipid plaques true TCFA as defined by histology. Comparing IVUS and OCT qualitative characteristics of the stented segments OCT detected more thrombus protrusions and proximal and distal stent edge dissections compared to IVUS (92.5 vs. 55%, p = 0.001; 20% vs. 7.5%, p = 0.03 and 25% vs. 5%, p < 0.001, respectively). Conclusions: Due to its superior resolution, OCT identifies TCFA more precisely. OCT more often shows remaining problems related to stent implantation than IVUS after angiographically guided PCI.
dc.affiliationpl
Wydział Lekarski : Instytut Kardiologii
dc.cm.date
2021-02-15
dc.cm.id
100405
dc.contributor.authorpl
Mrevlje, Blaz
dc.contributor.authorpl
Kleczyński, Paweł - 148282
dc.contributor.authorpl
Kranjec, Igor
dc.contributor.authorpl
Jąkała, Jacek
dc.contributor.authorpl
Noc, Marco
dc.contributor.authorpl
Rzeszutko, Łukasz - 354634
dc.contributor.authorpl
Dziewierz, Artur - 241962
dc.contributor.authorpl
Wizimirski, Marcin
dc.contributor.authorpl
Dudek, Dariusz - 129271
dc.contributor.authorpl
Legutko, Jacek - 130630
dc.date.accessioned
2021-02-15T01:20:46Z
dc.date.available
2021-02-15T01:20:46Z
dc.date.issuedpl
2020
dc.date.openaccess
0
dc.description.accesstime
w momencie opublikowania
dc.description.numberpl
2 (60)
dc.description.physicalpl
145-152
dc.description.points
40
dc.description.version
ostateczna wersja wydawcy
dc.description.volumepl
16
dc.identifier.doipl
10.5114/aic.2020.96057
dc.identifier.eissnpl
1897-4295
dc.identifier.issnpl
1734-9338
dc.identifier.projectpl
ROD UJ / OP
dc.identifier.uri
https://ruj.uj.edu.pl/xmlui/handle/item/263739
dc.languagepl
eng
dc.language.containerpl
eng
dc.rights*
Udzielam licencji. Uznanie autorstwa - Użycie niekomercyjne - Na tych samych warunkach 4.0 Międzynarodowa
dc.rights.licence
CC-BY-NC-SA
dc.rights.uri*
http://creativecommons.org/licenses/by-nc-sa/4.0/legalcode.pl
dc.share.type
otwarte czasopismo
dc.subject.enpl
percutaneous coronary intervention
dc.subject.enpl
acute myocardial infarction
dc.subject.enpl
optical coherence tomography
dc.subject.enpl
intravascular ultrasound
dc.subject.enpl
thin-cap fibroatheroma
dc.subject.enpl
culprit lesion
dc.subtypepl
Article
dc.titlepl
Optical coherence tomography versus intravascular ultrasound for culprit lesion assessment in patients with acute myocardial infarction
dc.title.journalpl
Postępy w Kardiologii Interwencyjnej
dc.typepl
JournalArticle
dspace.entity.type
Publication

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