[Characterization of atherosclerotic plaque in patients with unstable angina pectoris and stable angina pectoris by optical coherence tomography].

OBJECTIVE: To compare the characterization of coronary atherosclerotic plaques in patients with unstable angina pectoris (UAP) and stable angina pectoris (SAP) by optical coherence tomography (OCT). METHODS: OCT was performed in 47 patients (23 UAP and 24 SAP) undergoing coronary angiography. Lipid-rich plaque (defined by > or = 2 quadrants of the cross-section area), thin cap fibroatheroma (TCFA), thickness of fibrous cap, plaque rupture, calcification and thrombus visualized by OCT were compared between UAP and SAP patients. RESULTS: OCT imaging was successfully in 44 out of 47 patients (22 UAP, 22 SAP). Proportion of lipid-rich plaques was similar between UAP and SAP groups [91% (20/22) vs. 73% (16/22), P = 0.741]. The minimum thickness of fibrous cap in the UAP group was significantly thinner than that in SAP group [(69.5 +/- 34.7) microm vs. (141.1 +/- 68.5) microm, P = 0.000] and the rate of fibrous cap erosion in the UAP group was significantly higher than that in the SAP group [59% (13/22) vs. 9% (2/22), P = 0.000]. Percents of TCFA [73% (16/22) vs. 14% (3/22), P = 0.000] and plaque rupture [50% (11/22) vs. 9% (2/22), P = 0.003] were significantly higher in UAP group compared those in SAP group. Incidence of thrombus and calcification were similar between two groups. CONCLUSIONS: OCT imaging can clearly define plaque characterization of coronary atherosclerosis. UAP patients have thinner fibrous cap, higher incidences of fibrous cap erosion, plaque rupture and TCFA compared patients with SAP.

[Visualization of intimal proliferation of drug-eluting stent and bare mental stent by use of optical coherence tomography].

OBJECTIVE: To compare neointimal proliferation of drug-eluting stent (DES) with bare mental stent (BMS) by optical coherence tomography (OCT). METHODS: OCT images were obtained in 21 diseased coronary vessels with 23 stents in 19 patients with coronary artery disease at 5 - 93 months post DES or BMS stents. Twenty-two stents of all 23 stents were divided into three groups. Nine DES stents at 6 - 10 months post stenting were considered as group A, 8 BMS stents at 5 - 10 months post stenting as group B, and 5 BMS stents at 23 - 93 months post stenting as group C. OCT images were quantitatively analyzed to compare neointimal proliferation of three groups after stenting. RESULTS: All 21 vessels and 23 stents OCT images were successfully acquired. The maximal neointima, luminal loss in diameter and cross sectional area (CSA), and restenosis in diameter and CSA were significantly statistically different within three groups. The maximal intimal proliferations post stenting in group A were significantly lower than group B (0.20 mm +/- 0.13 mm vs 0.81 mm +/- 0.46 mm, P = 0.019) or group C (0.91 mm +/- 0.27 mm, P = 0.007), luminal loss of diameter in group A were significantly lower than group B (0.27 mm +/- 0.17 mm vs 1.12 mm +/- 0.79 mm, P = 0.009) or group C (1.20 mm +/- 0.31 mm, P = 0.013), restenosis rates in diameter in group A were significantly less than group B (8.90% +/- 4.47% vs 36.36% +/- 24.34%, P = 0.009) or group C (35.48 +/- 6.09, P = 0.017), luminal loss in CSA in group A were lower than group B (1.14 mm(2) +/- 0.9 mm(2) vs 3.96 mm(2) +/- 2.62 mm(2), P = 0.009) or group C (4.66 mm(2) +/- 1.66 mm(2), P = 0.006), and restenosis rates in CSA in group A were less than group B (15.43% +/- 7.89% vs 48.14% +/- 30.43%, P = 0.017) or group C (55.20% +/- 11.24%, P = 0.009). Almost all surfaces of 13 BMS stent struts were covered by significant neointimal coverage, surfaces of 10 DES struts were less significantly neointimal coverage, and some surfaces of DES struts were uncovered with neointima even at 29 months post stenting. CONCLUSION: OCT imaging can clearly visualize stent struts and neointimal formation of strut surfaces post DES or BMS stenting, and this new imaging modality will play important role in evaluating the efficacy of drug-eluting stent.

[Coronary artery atherosclerotic plaque and stent visualizations by optical coherence tomography].

OBJECTIVE: To evaluate coronary artery atherosclerotic plaque characteristics and changes post coronary stenting by optical coherence tomography (OCT). METHODS: OCT images were obtained in 22 diseased coronary vessels after coronary angiography or percutaneous coronary interventions (PCI) in 20 patients and in 23 stents [7 sirolimus-eluting stents (SES) follow up at 4-29 months post stenting and 8 bare mental stents (BMS) at 4-35 months post stenting, 8 stents immediately after PCI]. RESULTS: All 22 vessels and 23 stents OCT images were successfully acquired. Two thromboses, 8 fibrous, 9 lipid-rich and 3 calcium plaques as well as 3 plaque ruptures were visualized by OCT. No significant neointimal proliferation and restenosis were found in SES stents and some struts were not covered with neointima even at 29 months post stenting. Significant neointimal proliferation on surfaces of stent struts were visualized in all 8 BMS stents and restenosis was detected in 3 BMS stents. OCT images obtained immediately after PCI showed that 3 stents were well positioned, tissue prolapse between coronary stent struts occurred in 4 stents and stent dissociation with vessel wall could be seen in 1 stent. CONCLUSIONS: OCT imaging can clearly visualize different types of atherosclerotic plaques. By providing detailed information on plaque characteristics, this technique might help cardiologists in choosing suitable stents and guiding preventive therapy for patients with coronary heart disease.