Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan.
Int J Cardiol. 2011 Jan 21;146(2):186-90. doi: 10.1016/j.ijcard.2009.06.059. Epub 2009 Aug 7.
Optical coherence tomography (OCT) has been introduced as a high-resolution imaging modality for the coronary arteries. The current OCT system, however, has a serious limitation in that the image acquisition method requires a soft balloon occlusion to avoid signal scattering from red blood cells.
The purpose of this study was to compare OCT images from the conventional balloon occlusion method and a non-occlusion image acquisition method, the continuous-flushing method, in the clinical setting.
OCT was performed with the conventional balloon occlusion method and the continuous-flushing method sequentially in 23 patients with stable angina. The image quality and quantitative measurements of OCT images were directly compared between the two methods.
There were no adverse events related to the OCT procedure in any patients. There were no changes in systolic blood pressure and heart rate during the OCT procedure. ST-segment elevation (>2 mm) was recorded in 22 of 23 (96%) patients with the balloon occlusion method, but it was only observed in 1 of 23 (4%) patients with the continuous-flushing method (p<0.01). There were no differences in the visible length (the balloon occlusion method 28.6±2.3 mm vs. the continuous-flushing method 29.2±1.6 mm, p=0.49), image quality, or quantitative measurements between the two methods.
OCT imaging with the continuous-flushing method could be performed safely and obtained similar quality images compared with the balloon occlusion method. OCT can be used to observe the proximal site of coronary arteries with this new technique.
光学相干断层扫描（OCT）已被引入冠状动脉的高分辨率成像方式。然而，当前的 OCT 系统存在一个严重的局限性，即图像采集方法需要软球囊闭塞以避免来自红细胞的信号散射。
本研究旨在比较传统球囊闭塞法和非闭塞图像采集法（连续冲洗法）在临床环境中的 OCT 图像。
对 23 例稳定性心绞痛患者依次进行 OCT 检查，采用传统球囊闭塞法和连续冲洗法。直接比较两种方法的图像质量和 OCT 图像的定量测量。
在任何患者中均无与 OCT 程序相关的不良事件。在 OCT 过程中，收缩压和心率均无变化。在 23 例患者中，有 22 例（96%）在球囊闭塞法中记录到 ST 段抬高（>2mm），而在连续冲洗法中仅观察到 1 例（4%）（p<0.01）。两种方法的可见长度（球囊闭塞法 28.6±2.3mm 与连续冲洗法 29.2±1.6mm，p=0.49）、图像质量或定量测量均无差异。
与球囊闭塞法相比，连续冲洗法的 OCT 成像可安全进行，并获得相似质量的图像。OCT 可用于观察冠状动脉的近端部位。
