Wu Wei, Zhao Shijia, Banga Akshat, Trivedi Yash Vardhan, Dasari Vineeth S, Munjal Parth, Bhat Rakshita Ramesh, Tapia-Orihuela Ruben K A, Oguz Usama M, Zafar Hammad, Darapaneni Haritha, Spilias Nikolaos, Wagner Jessica, Morin Stephen, DeVos Amanda, Iaizzo Paul A, Maehara Akiko, Shlofmitz Evan S, Ali Ziad A, Brilakis Emmanouil, Dangas George D, Johnson Thomas, Chatzizisis Yiannis S
Center for Digital Cardiovascular Innovations, Cardiovascular Division, Miller School of Medicine, Miami, Florida.
Department of Chemistry, University of Nebraska-Lincoln, Hamilton Hall, Lincoln, Nebraska.
J Soc Cardiovasc Angiogr Interv. 2025 May 1;4(5):102520. doi: 10.1016/j.jscai.2024.102520. eCollection 2025 May.
Complex percutaneous coronary interventions rely on advanced intravascular imaging techniques, such as intravascular ultrasound (IVUS) and optical coherence tomography (OCT). This study aims to compare the accuracy of the latest high-definition intravascular ultrasound (HD IVUS) and OCT technologies in measuring coronary lumen dimensions and assessing plaque morphology.
We compared HD IVUS and OCT in 8 silicone models using microcomputed tomography as the ground truth. We also compared HD IVUS vs OCT in 12 coronary arteries from 9 patients.
In the silicone models, the latest HD IVUS (AVVIGO+, Boston Scientific) system overestimated lumen dimensions compared to microcomputed tomography by +0.06 ± 0.05 mm for mean lumen diameter (MLD). OCT (Ultreon 2.0, Abbott) underestimated lumen dimensions by -0.17 ± 0.06 mm for MLD, with the underestimation being greater for lumen diameters ≥5.0 mm. In clinical cases, the latest HD IVUS (AVVIGO+) system yielded larger lumen dimensions compared to OCT (Ultreon 2.0) by +0.12 ± 0.11 mm for MLD, and the earlier HD IVUS (POLARIS, Boston Scientific) system also showed larger lumen dimensions compared to OCT (AptiVue, Abbott) by +0.26 ± 0.29 mm for MLD. Using OCT as the reference, HD IVUS detected fine wall structures with precision, such as a thin fibrous cap, dissection, and stent struts.
The latest HD IVUS (Avvigo+) tends to overestimate lumen size, whereas OCT (Ultreon 2.0) underestimates it. Experimental data suggest HD IVUS provides more accurate lumen assessment, particularly in larger coronary arteries, although both technologies exhibit comparable overall accuracy in the clinical setting.
复杂的经皮冠状动脉介入治疗依赖于先进的血管内成像技术，如血管内超声（IVUS）和光学相干断层扫描（OCT）。本研究旨在比较最新的高清血管内超声（HD IVUS）和OCT技术在测量冠状动脉管腔尺寸和评估斑块形态方面的准确性。
我们使用微型计算机断层扫描作为金标准，在8个硅胶模型中比较了HD IVUS和OCT。我们还在9例患者的12条冠状动脉中比较了HD IVUS与OCT。
在硅胶模型中，最新的HD IVUS（AVVIGO +，波士顿科学公司）系统与微型计算机断层扫描相比，平均管腔直径（MLD）高估管腔尺寸0.06±0.05mm。OCT（Ultreon 2.0，雅培公司）低估MLD的管腔尺寸0.17±0.06mm，对于管腔直径≥5.0mm的情况，低估更为明显。在临床病例中，最新的HD IVUS（AVVIGO +）系统与OCT（Ultreon 2.0）相比，MLD的管腔尺寸大0.12±0.11mm，而早期的HD IVUS（POLARIS，波士顿科学公司）系统与OCT（AptiVue，雅培公司）相比，MLD的管腔尺寸也大0.26±0.29mm。以OCT为参考，HD IVUS能够精确检测细壁结构，如薄纤维帽、夹层和支架支柱。
最新的HD IVUS（Avvigo +）往往高估管腔大小，而OCT（Ultreon 2.0）则低估管腔大小。实验数据表明，HD IVUS能提供更准确的管腔评估，特别是在较大的冠状动脉中，尽管两种技术在临床环境中总体准确性相当。
