title: Assessment of coronary arterial thrombus by optical coherence tomography.
abstract: We analyzed optical coherence tomographic (OCT) characteristics of different types of coronary thrombi that had been confirmed at postmortem histologic examination. We examined 108 coronary arterial segments of 40 consecutive human cadavers. OCT images of red and white thrombi were obtained and the intensity property of these thrombi was analyzed. Red and white thrombi were found in 16 (17%) and 19 (18%) of the 108 arterial segments, respectively. Red thrombi were identified as high-backscattering protrusions inside the lumen of the artery, with signal-free shadowing in the OCT image. White thrombi were identified as low-backscattering projections in the OCT image. There were no significant differences in peak intensity of OCT signal between red and white thrombi (130+/-18 vs 145+/-34, p=0.12). However, the 1/2 attenuation width of the signal intensity curve, which was defined as the distance from peak intensity to its 1/2 intensity, was significantly different between red and white thrombi (324+/-50 vs 183+/- 42 microm, p<0.0001). A cut-off value of 250 microm in the 1/2 width of signal intensity attenuation can differentiate white from red thrombi with a sensitivity of 90% and specificity of 88%. We present the first detailed description of the characteristics of different types of coronary thrombi in OCT images. Optical coherence tomography may allow us not only to estimate plaque morphology but also to distinguish red from white thrombi.
authors.affiliation: Department of Cardiology, Kawasaki Medical School, Kurashiki, Japan. tteru@med.kawasaki-m.ac
authors.forename: Teruyoshi
authors.initials: T
authors.lastname: Kume
authors.forename: Takashi
authors.initials: T
authors.lastname: Akasaka
authors.forename: Takahiro
authors.initials: T
authors.lastname: Kawamoto
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Ogasawara
authors.forename: Nozomi
authors.initials: N
authors.lastname: Watanabe
authors.forename: Eiji
authors.initials: E
authors.lastname: Toyota
authors.forename: Yoji
authors.initials: Y
authors.lastname: Neishi
authors.forename: Renan
authors.initials: R
authors.lastname: Sukmawan
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Sadahira
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Yoshida
mesh_terms: D000368:Aged; D002102:Cadaver; D003328:Coronary Thrombosis / Q000473:pathology*; D003331:Coronary Vessels / Q000473:pathology*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D012680:Sensitivity and Specificity; D041623:Tomography, Optical Coherence