Usefulness of optical coherence tomography with angiographic coregistration in the guidance of coronary stent implantation
Usefulness of optical coherence tomography with angiographic coregistration in the guidance of coronary stent implantation
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光学相干断层扫描与血管造影协同配准在指导冠状动脉支架植入中的作用
DOI：
10.1007/s00380-021-01911-1
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发表时间：
2021
影响因子：
1.5
通讯作者：
Akasaka Takashi
中科院分区：
文献类型：
--
作者：
Kubo Takashi;Ino Yasushi;Shiono Yasutsugu;Terada Kosei;Emori Hiroki;Higashioka Daisuke;Takahata Masahiro;Wada Teruaki;Shimamura Kunihiro;Khalifa Amir Kh. M.;Tu Shengxian;Akasaka Takashi
光学相干断层扫描(OCT)-血管成像在支架植入过程中的联合配准可能有助于避免地理错配和不完整的病变覆盖。支架边缘未处理的富脂斑块与支架边缘再狭窄相关。本研究试图比较OCT引导下的经皮冠状动脉介入治疗(PCI)在OCT血管造影联合配准和不配准的情况下支架边缘未经处理的富脂斑块的发生率。我们调查了398例在OCT引导下植入支架的患者(联合注册组n= 198例，非联合注册组n= 200例)。在经皮冠状动脉介入治疗后的OCT中，通过5 mm支架边缘段最大脂弧 >； 180˚来识别未经处理的脂溢性斑块。联合注册组和非联合注册组之间的PCI靶向病变特征和支架长度没有差异。联合注册组近端或远端支架边缘段未经处理的富脂斑块的发生率显著低于非联合注册组(16%比26%，P= 0.015)。支架边缘夹层(5%vs.6%，P= 0.516)和未经治疗的狭窄(2%vs.3%，P= 0.724)发生率较低，两组间差异无统计学意义。在OCT引导的经皮冠状动脉介入治疗中，OCT血管造影术联合配准的使用与支架边缘未经处理的富脂斑块的发生率降低有关。OCT血管成像联合配准对经皮冠状动脉介入治疗结果有积极影响。
Optical coherence tomography (OCT)-angiography coregistration during stent implantation may be useful to avoid geographical mismatch and incomplete lesion coverage. Untreated lipid-rich plaque at stent edge is associated with subsequent stent edge restenosis. The present study sought to compare the frequency of untreated lipid-rich plaque at the stent edge between OCT-guided percutaneous coronary intervention (PCI) with and without OCT-angiography coregistration. We investigated 398 patients who underwent OCT-guided stent implantation (n= 198 in the coregistration group, andn= 200 in the no coregistration group). In OCT after PCI, untreated lipid-lich plaque was identified by the maximum lipid arc > 180˚ in the 5-mm stent edge segment. The PCI-targeted lesion characteristics and stent length were not different between the coregistration group and the no coregistration group. The frequency of untreated lipid-rich plaque in either proximal or distal stent edge segment was significantly lower in the coregistration group than in the no coregistration group (16% vs. 26%,P= 0.015). The frequency of stent-edge dissection (5% vs. 6%,P= 0.516) and untreated stenosis (2% vs. 3%,P= 0.724) was low and without significant differences between the two groups. In OCT-guided PCI, the use of OCT-angiography coregistration was associated with a reduced frequency of untreated lipid-rich plaque at stent edges. OCT-angiography coregistration has a positive impact on PCI results.