Soonchunhyang Med Sci.  2021 Jun;27(1):5-10. 10.15746/sms.21.002.

The Optical Coherence Tomographic Findings Which Predict Outcome of Calcified Coronary Lesions after Percutaneous Coronary Intervention: A Serial Follow-up Study

• Jang J
• Kang SH
• Cho YS
• Shin ES
• Suh JW

• KMID: 2517783
• DOI: http://doi.org/10.15746/sms.21.002

Abstract

Objective
Imaging modalities such as intravascular ultrasonography or computed tomography or angiography have shown limitations in assessing coronary calcification. In this study, we investigated whether quantitative indices of optical coherence tomography (OCT) in calcified lesions are correlated with the late outcome of a coronary stent.
Methods
We consecutively enrolled patients who had more than grade 2 coronary calcification on fluoroscopy. OCT was performed at baseline, immediately after stenting, and at 9 months after stenting. We analyzed qualitative and quantitative characteristics of plaque, calcification, and stent-related indices.
Results
All images of 3-time points were available in a total of 10 patients. Calcified lesions were frequently associated with thin cap fibroatheroma (100%), plaque erosion (20%), or rupture (20%) before the procedure. Thrombus was found in 100% of cases in the OCT immediately after stenting. Maximal calcium area before stenting was strongly correlated with late luminal loss assessed by 9-month follow-up OCT (r= 0.766, P= 0.01).
Conclusion
Preprocedural OCT assessment on calcified coronary lesion may predict high-risk procedure and late stent outcome. Further studies are warranted to confirm these findings.

Keyword

Optical coherence tomography; Calcification; Stents; Restenosis; Atherosclerosis