Clinical Research
Optical Coherence Tomography Versus Intravascular Ultrasound to Evaluate Coronary Artery Disease and Percutaneous Coronary Intervention

https://doi.org/10.1016/j.jcin.2012.09.017Get rights and content
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Objectives

We 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 mm2 versus 3.32 ± 1.92 mm2, 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.

Key Words

intravascular ultrasound
optical coherence tomography
percutaneous coronary intervention

Abbreviations and Acronyms

FD-OCT
frequency-domain optical coherence tomography
IVUS
intravascular ultrasound
MLA
minimal lumen area
NIH
neointimal hyperplasia
OCT
optical coherence tomography
PCI
percutaneous coronary intervention
TD-OCT
time-domain optical coherence tomography

Cited by (0)

Dr. Bezerra has received consulting fees and honoraria from St. Jude Medical, Inc; Dr. Attizzani has received consulting fees from St Jude Medical, Inc.; Dr. Sirbu has received research funding from St. Jude Medical, Inc.; Dr. Guagliumi has received consulting fees from St. Jude Medical, Inc., Boston Scientific, and Volcano, and grant support from St. Jude Medical, Inc., Medtronic Vascular, LightLab Imaging, Boston Scientific, and Abbott Vascular; Dr. Costa has received consulting fees from St. Jude Medical, Inc., Medtronic, Scitech, Cordis, Boston Scientific, and Abbott Vascular. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. The first 2 authors contributed equally to this paper.