Serial Assessment of Tissue Precursors and Progression of Coronary Calcification Analyzed by Fusion of IVUS and OCT: 5-Year Follow-Up of Scaffolded and Nonscaffolded Arteries
Yaping Zeng, Hiroki Tateishi, Rafael Cavalcante, Erhan Tenekecioglu, Pannipa Suwannasom, Yohei Sotomi, Carlos Collet, Shaoping Nie, Hans Jonker, Jouke Dijkstra, Maria D Radu, Lorenz Räber, Dougal R McClean, Robert-Jan van Geuns, Evald H Christiansen, Therese Fahrni, Jacques Koolen, Yoshinobu Onuma, Nico Bruining, Patrick W Serruys, Yaping Zeng, Hiroki Tateishi, Rafael Cavalcante, Erhan Tenekecioglu, Pannipa Suwannasom, Yohei Sotomi, Carlos Collet, Shaoping Nie, Hans Jonker, Jouke Dijkstra, Maria D Radu, Lorenz Räber, Dougal R McClean, Robert-Jan van Geuns, Evald H Christiansen, Therese Fahrni, Jacques Koolen, Yoshinobu Onuma, Nico Bruining, Patrick W Serruys
Abstract
Objectives: The aim of this study was to assess calcium growth with fused grayscale intravascular ultrasound (IVUS), IVUS-virtual histology, and optical coherence tomography (OCT) from baseline to 5-year follow-up in patients treated with bioresorbable vascular scaffolds.
Background: IVUS and OCT have individual strengths in assessing plaque composition and volume. Fusion of images obtained using these methods could potentially aid in coronary plaque assessment.
Methods: Anatomic landmarks and endoluminal radiopaque markers were used to fuse OCT and IVUS images and match baseline and follow-up.
Results: Seventy-two IVUS-virtual histology and OCT paired matched cross-sectional in- and out-scaffold segments were fused at baseline and follow-up. In total, 46 calcified plaques at follow-up were detected using the fusion method (33 in-scaffold, 13 out-scaffold), showing either calcium progression (52.2%) or de novo calcifications (47.8%). On OCT, calcification volume increased from baseline to follow-up by 2.3 ± 2.4 mm3 (p = 0.001). The baseline virtual histologic tissue precursors of dense calcium at follow-up were necrotic core in 73.9% and fibrous or fibrofatty plaque in 10.9%. In 15.2%, calcium was already present at baseline. Precursors on OCT were lipid pool in 71.2%, fibrous plaque in 4.3%, and fibrocalcific plaque in 23.9%.
Conclusions: The use of OCT and IVUS fusion imaging shows similar calcium growth in- and out-scaffold segments. Necrotic core is the most frequent precursor of calcification. The scaffold resorption process creates a tissue layer that re-caps the calcified plaques. (Absorb Clinical Investigation, Cohort B [ABSORB B]; NCT00856856).
Keywords: bioresorbable vascular scaffold; calcification; fusion.
Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Source: PubMed