Feasibility of combined use of intravascular ultrasound radiofrequency data analysis and optical coherence tomography for detecting thin-cap fibroatheroma.
OBJECTIVE
To evaluate the feasibility of the combined use of virtual histology (VH)-intravascular ultrasound (IVUS) and optical coherence tomography (OCT) for detecting in vivo thin-cap fibroatheroma (TCFA).


RESULTS
In 56 patients with angina, 126 plaques identified by IVUS findings were analysed using both VH-IVUS and OCT. IVUS-derived TCFA was defined as an abundant necrotic core (>10% of the cross-sectional area) in contact with the lumen (NCCL) and %plaque-volume >40%. OCT-derived TCFA was defined as a fibrous cap thickness of <65 microm overlying a low-intensity area with an unclear border. Plaque meeting both TCFA criteria was defined as definite-TCFA. Sixty-one plaques were diagnosed as IVUS-derived TCFA and 36 plaques as OCT-derived TCFA. Twenty-eight plaques were diagnosed as definite-TCFA; the remaining 33 IVUS-derived TCFA had a non-thin-cap and eight OCT-derived TCFA had a non-NCCL (in discord with NCCL visualized by VH-IVUS, mainly due to misreading caused by dense calcium). Based on IVUS findings, definite-TCFA showed a larger plaque and vessel volume, %plaque-volume, higher vessel remodelling index, and greater angle occupied by the NCCL in the lumen circumference than non-thin-cap IVUS-derived TCFA. Conclusion Neither modality alone is sufficient for detecting TCFA. The combined use of OCT and VH-IVUS might be a feasible approach for evaluating TCFA.
Sawada
Takahiro
T
Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Hyogo, 650-0017, Japan.
Shite
Junya
J
Garcia-Garcia
Hector M
HM
Shinke
Toshiro
T
Watanabe
Satoshi
S
Otake
Hiromasa
H
Matsumoto
Daisuke
D
Tanino
Yusuke
Y
Ogasawara
Daisuke
D
Kawamori
Hiroyuki
H
Kato
Hiroki
H
Miyoshi
Naoki
N
Yokoyama
Mitsuhiro
M
Serruys
Patrick W
PW
Hirata
Ken-ichi
K
D054058:Acute Coronary Syndrome / Q000209:etiology; D000368:Aged; D000787:Angina Pectoris / Q000209:etiology; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D009336:Necrosis / Q000473:pathology; D015588:Observer Variation; D010865:Pilot Projects; D013223:Statistics as Topic; D041623:Tomography, Optical Coherence / Q000379:methods*; D018084:Ultrasonography, Interventional / Q000379:methods*