Second-Generation Optical Coherence Tomography in Clinical Practice. High-Speed Data Acquisition Is Highly Reproducible in Patients Undergoing Percutaneous Coronary Intervention
Second-Generation Optical Coherence Tomography in Clinical Practice. High-Speed Data Acquisition Is Highly Reproducible in Patients Undergoing Percutaneous Coronary Intervention
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DOI：
10.1016/s0300-8932(10)70201-3
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发表时间：
2010-08-01
影响因子：
5.9
通讯作者：
Regar, Evelyn
中科院分区：
文献类型：
--
作者：
Gonzalo, Nieves;Tearney, Guillermo J.;Regar, Evelyn
简介和目标。第二代光学相干断层扫描（即傅里叶域光学相干断层扫描，FD-OCT）的发展使得在图像采集过程中进行高速回拉成为可能，而无需短暂闭塞冠状动脉。本研究的目的是评估 FD-OCT 系统在表征斑块和评估接受经皮冠状动脉介入治疗的患者的支架植入方面的可重复性。方法。该研究包括 2008 年 5 月至 12 月期间入组的 45 名计划接受经皮冠状动脉介入治疗的患者。通过 FD-OCT 使用非闭塞技术并采用 5 至 20 mm/s 的回拉速度进行图像采集。评估了斑块特征和支架分析的研究间、观察者间和观察者内的再现性。结果。所有患者 (n=45) 均成功进行了傅里叶域成像。平均冲洗速率为 3 +/- 0.4 mL/s，每次拉回的造影剂体积为 16.1 +/- 3.5 mL。平均回拉持续时间和长度分别为 3.2 +/- 1.2 秒和 53.3 +/- 12.4 毫米。可视化边缘剥离、组织脱垂、支架内剥离和贴壁不良的研究间再现性非常好（kappa=1）。研究间、观察者间和观察者内对斑块特征的一致性的 kappa 值分别为 0.92、0.82 和 0.95。结论。涉及高速数据采集的第二代 OCT 系统（即 FD-OCT）在表征斑块和评估接受经皮冠状动脉介入治疗的患者的支架植入方面表现出良好的研究间、观察者间和观察者内的再现性。
Introduction and objectives. The development of second-generation optical coherence tomography (i.e. Fourier domain optical coherence tomography, FD-OCT) has made it possible to perform high speed pullbacks during image acquisition without the need for transient occlusion of the coronary artery. The objective of this study was to assess the reproducibility of FD-OCT systems for characterizing plaque and evaluating stent implantation in patients undergoing a percutaneous coronary intervention.Methods. The study included 45 patients scheduled for percutaneous coronary intervention who were enrolled between May and December 2008. Image acquisition was performed by FD-OCT using a non-occlusive technique and employing pullback speeds ranging from 5 to 20 mm/s. Interstudy, interobserver and intraobserver reproducibility of plaque characterization and stent analysis were assessed.Results. Fourier domain imaging was successfully performed in all patients (n=45). The average flush rate was 3 +/- 0.4 mL/s and the contrast volume per pullback was 16.1 +/- 3.5 mL. The mean pullback duration and length were 3.2 +/- 1.2 s and 53.3 +/- 12.4 mm, respectively. The interstudy reproducibility for visualizing edge dissection, tissue prolapse, intrastent dissection and malapposition was excellent (kappa=1). The kappa values for interstudy, interobserver and intraobserver agreement on plaque characterization were 0.92, 0.82 and 0.95, respectively.Conclusions. A second-generation OCT system (i.e. FD-OCT) involving high-speed data acquisition demonstrated good interstudy, interobserver and intraobserver reproducibility for characterizing plaque and evaluating stent implantation in patients undergoing a percutaneous coronary intervention.