Harrington Heart and Vascular Institute, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, OH 44106, USA.
JACC Cardiovasc Interv. 2013 Mar;6(3):228-36. doi: 10.1016/j.jcin.2012.09.017.
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.
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.
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.
FD-OCT depicted more severe native coronary disease than IVUS; minimal lumen area (MLA) was 2.33 ± 1.56 mm(2) versus 3.32 ± 1.92 mm(2), 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.
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.
我们比较了血管内超声（IVUS）和两种不同代的光学相干断层扫描（OCT）——时域 OCT（TD-OCT）和频域 OCT（FD-OCT）——在评估冠状动脉疾病和经皮冠状动脉介入治疗（PCI）中使用支架的情况。
OCT 是一种很有前途的基于光的血管内成像方式，其分辨率高于 IVUS。然而，由于 OCT 图像定量数据的缺乏，限制了其在临床实践中的应用。
共研究了 227 例 OCT 和 IVUS 拉回数据。比较了 100 例非支架（n = 56）和支架（n = 44）血管中 FD-OCT 和 IVUS 拉回，另外，比较了 127 例支架血管中 TD-OCT 和 IVUS 图像。
FD-OCT 比 IVUS 显示更严重的原发性冠状动脉疾病；最小管腔面积（MLA）分别为 2.33 ± 1.56 mm²和 3.32 ± 1.92 mm²（p < 0.001）。FD-OCT 和 IVUS 在原发性和支架冠状动脉中的参考血管尺寸相当，但 TD-OCT 检测到的参考管腔尺寸小于 IVUS。即刻 PCI 后，支架内 MLA 在 FD-OCT 和 IVUS 之间相似，但在随访时，FD-OCT 和 TD-OCT 均检测到比 IVUS 更小的 MLA，这可能是由于更好地检测到新生内膜增生（NIH）。FD-OCT 更频繁地发现 PCI 后贴壁不良和组织脱垂。
FD-OCT 生成的参考管腔尺寸相似，但病变严重程度和 NIH 更高，并且比 IVUS 更好地检测到贴壁不良和组织脱垂。第一代 TD-OCT 与 IVUS 相比，参考血管尺寸更小。
