急性光学相干断层成像术评价 ST 段抬高型心肌梗死中的血栓特征。

Thrombus characteristics evaluated by acute optical coherence tomography in ST elevation myocardial Infarction.

机构信息

Department of Heart Disease, Haukeland University Hospital, Bergen, Norway.

Department of Clinical Science, University of Bergen, Bergen, Norway.

出版信息

PLoS One. 2022 Apr 11;17(4):e0266634. doi: 10.1371/journal.pone.0266634. eCollection 2022.

AIMS

ST elevation myocardial infarction (STEMI) is caused by an occlusive thrombosis of a coronary artery. We wanted to assess if the thrombus can be characterized according to erythrocyte content and age using intravascular optical coherence tomography (OCT) in a clinical setting.

METHODS AND RESULTS

We performed manual thrombus aspiration in 66 STEMI patients. OCT was done of the thrombus remnants after aspiration. A light intensity ratio was measured through the thrombus. Forty two of the aspirates had thrombus which could be analyzed histomorphologically for analysis of erythrocyte and platelet content, and to determine the age of thrombus as fresh, lytic or organized. There were 11 red, 21 white and 10 mixed thrombi. Furthermore, 36 aspirates had elements of fresh, 7 of lytic and 8 of organized thrombi. There was no correlation between colour and age. OCT appearance could not predict erythrocyte or platelet content. The light intensity ratios were not significantly different in fresh, lytic or organized thrombi.

CONCLUSION

OCT could not differentiate between red and white thrombi, nor determine thrombus age.

目的

ST 段抬高型心肌梗死（STEMI）是由冠状动脉阻塞性血栓形成引起的。我们希望评估在临床环境中是否可以使用血管内光学相干断层扫描（OCT）根据红细胞含量和年龄对血栓进行特征描述。

方法和结果

我们对 66 例 STEMI 患者进行了手动血栓抽吸。抽吸后对血栓残留进行 OCT 检查。通过血栓测量光强度比。42 个抽吸物的血栓可进行组织形态学分析，以分析红细胞和血小板含量，并确定血栓的新鲜度、溶解或机化程度。有 11 个红色血栓、21 个白色血栓和 10 个混合血栓。此外，36 个抽吸物有新鲜血栓的成分，7 个有溶解血栓的成分，8 个有机化血栓的成分。颜色与年龄之间没有相关性。OCT 表现不能预测红细胞或血小板含量。新鲜、溶解或机化血栓的光强度比没有显著差异。