Coronary artery diseaseAssessment of Culprit and Remote Coronary Narrowings Using Optical Coherence Tomography With Long-Term Outcomes
Section snippets
Methods
From February to August 2004, this single-center observational pilot study examined patients with coronary artery disease. Twenty-three patients scheduled for coronary stent implantation underwent OCT before angioplasty. The culprit lesion and mild to moderate coronary lesions remote from the target stenosis were investigated. Patients were selected based on the presence of stable or unstable angina pectoris with objective evidence of ischemia. Clinical exclusion criteria were poor renal
Results
Baseline clinical and lesion characteristics are listed in Table 1. There was 1 case of transient atrioventricular block during OCT pullback in a 72-year-old man with single-vessel disease. The rest of his clinical course was uneventful, and he was discharged as planned the next day.
OCT analysis of the coronary artery wall was possible in all patients. Mean OCT pullback length was 28.8 ± 12.2 mm. Quantitative measurements at the culprit site showed a mean minimal lumen area and mean minimal
Discussion
The main findings of this study were that (1) OCT could be safely used in vivo to show the heterogeneity of coronary plaques at culprit and remote sites, (2) intravascular OCT could detect in vivo morphologic features associated with plaque vulnerability using retrospective pathologic examination, and (3) the lack of long-term clinical events in our patients with TCFA gave unique antemortem insight into such lesions, although the sample size was small.
The recent introduction of OCT has proved
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