Komatsu Sei, Ohara Tomoki, Takahashi Satoru, Takewa Mitsuhiko, Yutani Chikao, Kodama Kazuhisa
Department of Cardiology, Cardiovascular Center, Osaka Gyoumeikan Hospital, 5-4-8, Nishi-kujo, Konohana-ku, Osaka, 554-0012, Japan.
Department of Pathology, Cardiovascular Center, Osaka Gyoumeikan Hospital, Osaka, Japan.
Int J Cardiovasc Imaging. 2017 Jun;33(6):789-796. doi: 10.1007/s10554-017-1079-1. Epub 2017 Feb 7.
Non-obstructive angioscopy (NOA) is used to visualize the surface of the coronary artery, and a clear visual field is obtained by injecting transparent fluid into the gap between the probing catheter and the fiber. This study examines visual field expansion by a dual infusion method, which involves an infusion from the probing and guiding catheters, and the relationships between visual grade and vessel characteristics. Thirty-two patients and thirty patients performed coronary plaque analysis with NOA using the conventional method and the novel dual infusion method, respectively. Images were blindly analyzed retrospectively. Visual fields were assessed from image slices using a 5-point scale (0 = invisible, 1 = poor, 2 = adequate, 3 = good, 4 = excellent) at 5-s intervals. The relationships between visual grade and vessel characteristics were analyzed using multiple stepwise linear regression analysis. The mean visual grade, "excellent" ratio, and "adequate" ratio were significantly higher using the dual infusion method than those obtained using the conventional method (p = 0.003, p = 0.004, and p = 0.005 respectively). The "invisible" ratio was significantly lower using the dual infusion method than the conventional method (p = 0.027). The visual field was negatively associated with the conventional method (β = -0.154, p < 0.001), large vessels (β = -0.004, p < 0.49), bifurcation (β = -0.205, p < 0.001), vessels with a sharp angle (β = -0.106, p < 0.001), in-stent (β = -0.180, p < 0.001), and distal border of stent (β = -0.075, p < 0.001); and positively associated with significant stenosis (β = 0.072, p < 0.001) and significantly covered stents (β = 0.050, p = 0.018). The visual field with NOA can be effectively expanded by the dual infusion method.
非阻塞性血管内镜检查（NOA）用于观察冠状动脉表面，通过向探测导管和光纤之间的间隙注入透明液体来获得清晰的视野。本研究考察了通过双灌注法（即从探测导管和引导导管进行灌注）实现的视野扩展，以及视觉分级与血管特征之间的关系。分别有32例患者和30例患者使用传统方法和新型双灌注法通过NOA进行冠状动脉斑块分析。对图像进行回顾性盲法分析。每隔5秒从图像切片中使用5分制（0 = 不可见，1 = 差，2 = 足够，3 = 良好，4 = 优秀）评估视野。使用多元逐步线性回归分析视觉分级与血管特征之间的关系。使用双灌注法时的平均视觉分级、“优秀”比例和“足够”比例显著高于使用传统方法时（分别为p = 0.003、p = 0.004和p = 0.005）。使用双灌注法时的“不可见”比例显著低于传统方法（p = 0.027）。视野与传统方法（β = -0.154，p < 0.001）、大血管（β = -0.004，p < 0.49）、分叉（β = -0.205，p < 0.001）、锐角血管（β = -0.106，p < 0.001）、支架内（β = -0.180，p < 0.001）以及支架远端边界（β = -0.075，p < 0.001）呈负相关；与显著狭窄（β = 0.072，p < 0.001）和显著覆盖支架（β = 0.050，p = 0.018）呈正相关。通过双灌注法可有效扩大NOA的视野。
