Optical Coherence Tomography: Current Applications for the Assessment of Coronary Artery Disease and Guidance of Percutaneous Coronary Interventions.
Optical Coherence Tomography: Current Applications for the Assessment of Coronary Artery Disease and Guidance of Percutaneous Coronary Interventions.
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DOI：
10.1007/s40119-020-00185-4
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发表时间：
2020-12
影响因子：
3.4
通讯作者：
Jukema JW
中科院分区：
文献类型：
--
作者：
Oosterveer TTM;van der Meer SM;Scherptong RWC;Jukema JW
冠状动脉造影术(CAG)是评估冠状动脉狭窄和经皮冠状动脉介入治疗(PCI)术中指导的标准方法。然而，CAG的局限性也得到了充分的认识。冠状动脉内成像(ICI)有可能克服这些局限性。血管内超声(IVUS)和光学相干断层成像(OCT)是临床应用的主要ICI技术。这篇叙述性的文献综述介绍了目前OCT在冠状动脉疾病(CAD)患者中与IVUS和CAG相关的临床应用。综述的项目包括：OCT和IVUS的技术含义、病变特征和决策、支架优化标准、支架植入后的结果、程序并发症、临床结果和适应症方面的安全性。由于其更高的分辨率，OCT能够比IVUS显示更多的细节。然而，较高的分辨率是以较低的穿透深度为代价的。支架植入前OCT导致超过50%的病例在支架长度和直径方面发生了程序上的改变。据报道，支架植入后OCT导致支架优化的病例至少有27%。错位和扩张不足用后扩张治疗，而边缘剥离则用额外的支架治疗。支架扩张、支架对位、支架远端边缘分离和参考管腔面积似乎是最重要的支架优化标准，对于决策和减少随访期间不良事件的风险都是如此。与单独的CAG相比，OCT和IVUS在支架置入后的效果上都更好。然而，对于OCT指导是否比IVUS指导更好的支架扩张，目前还没有达成共识。OCT、IVUS和CAG是安全的手术，几乎没有报告的手术并发症。总体而言，与仅CAG指南相比，OCT指南似乎有助于获得良好的临床结果。然而，OCT导引的临床结果与IVUS导引相似。在CAG解释仍不确定的更复杂的病例中，OCT可用于管腔评估和支架相关的形态学。由于OCT和IVUS有不同的特点，这些技术是互补的，应该根据这两种技术的优点和局限性仔细考虑每个患者的病例。本文的在线版本(10.1007/s40119-020-020-4)包含向授权用户提供的补充材料。
Coronary angiography (CAG) is the standard modality for assessment of coronary stenoses and intraprocedural guidance of percutaneous coronary interventions (PCI). However, the limitations of CAG are well recognized. Intracoronary imaging (ICI) can potentially overcome these limitations. Intravascular ultrasound (IVUS) and optical coherence tomography (OCT) are the main ICI techniques utilized in clinical practice. This narrative literature review addresses the current clinical applications of OCT in relation to IVUS and CAG in patients with coronary artery disease (CAD). Items reviewed are: technical implications of OCT and IVUS, lesion characterization and decision-making, stent optimization criteria, post-stenting results, safety in terms of procedural complications, clinical outcomes, and indications. OCT is able to reveal more detail than IVUS due to its higher resolution. However, this higher resolution comes at the cost of a lower penetration depth. Pre-stenting OCT results in procedural change in more than 50% of the cases in terms of stent length and diameter. Post-stenting OCT resulting in stent optimization is reported in at least 27% of the cases. Malapposition and under-expansion are treated with post-dilatations, while edge dissections are treated with additional stent placement. Stent expansion, stent apposition, distal stent edge dissections, and reference lumen areas seem to be the most important stent optimization criteria for both decision-making and for reducing the risk of adverse events during follow-up. Both OCT and IVUS are superior in terms of post-stenting results compared with CAG alone. However, there is no consensus about whether OCT guidance results in better stent expansion than IVUS guidance. OCT, IVUS, and CAG are safe procedures with few reported procedural complications. In general, OCT guidance seems to contribute to favorable clinical outcomes compared with CAG guidance only. However, OCT guidance results in similar clinical outcomes as with IVUS guidance. OCT could be considered for lumen assessment and stent-related morphology in more complex cases in which CAG interpretation remains uncertain. Since OCT and IVUS have distinct characteristics, these techniques are complementary and should be considered carefully for each patient case based on the benefits and limitations of both techniques. The online version of this article (10.1007/s40119-020-00185-4) contains supplementary material, which is available to authorized users.
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影响因子：
6.2
作者：
Imola, Fabrizio;Mallus, Maria Teresa;Prati, Francesco
通讯作者：
Prati, Francesco
DOI：
10.1007/s12471-018-1143-z
发表时间：
2018-10
期刊：
Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation
影响因子：
--
作者：
IJsselmuiden AJJ;Zwaan EM;Oemrawsingh RM;Bom MJ;Dankers FJWM;de Boer MJ;Camaro C;van Geuns RJM;Daemen J;van der Heijden DJ;Jukema JW;Kraaijeveld AO;Meuwissen M;Schölzel BE;Pundziute G;van der Harst P;van Ramshorst J;Dirksen MT;Zivelonghi C;Agostoni P;van der Heyden JAS;Wykrzykowska JJ;Scholte MJ;Nef HM;Kofflard MJM;van Royen N;Alings M;Kedhi E
通讯作者：
Kedhi E
影响因子：
5.7
作者：
Alfonso, Fernando;Dutary, Jaime;Macaya, Carlos
通讯作者：
Macaya, Carlos
影响因子：
37.8
作者：
Finn, Aloke V.;Joner, Michael;Virmani, Renu
通讯作者：
Virmani, Renu
影响因子：
120.7
作者：
Hong, Sung-Jin;Kim, Byeong-Keuk;Hong, Myeong-Ki
通讯作者：
Hong, Myeong-Ki