title: Visualization of internal carotid artery atherosclerotic plaques in symptomatic and asymptomatic patients: a comparison of optical coherence tomography and intravascular ultrasound.
abstract: OBJECTIVE
  OCT has been reported as a high-resolution imaging tool for characterizing plaque in the coronary arteries. The present study aimed to evaluate the ability of OCT to visualize carotid artery plaques compared with that of IVUS in asymptomatic and symptomatic patients.
  
  
  METHODS
  OCT was performed for 34 plaques (17 symptomatic, 17 asymptomatic) in 30 patients during CAS under a proximal cerebral protection method. OCT was performed before balloon angioplasty and after stent placement. IVUS was also performed just after OCT.
  
  
  RESULTS
  No technical or neurologic complications were encountered by using OCT. An inner catheter was used in 12 of 34 procedures (35.3%) for advancing the OCT image wire beyond the site of stenosis. OCT clearly visualized intraluminal thrombus in 15 of 34 plaques (44.1%), whereas IVUS detected a thrombus in 1 plaque (2.9%, P < .001). Neovascularization was demonstrated in 13 of 34 plaques (38.2%) by OCT, but not by IVUS (0%, P < .001). Intraluminal thrombus was more frequently observed in symptomatic plaques (13 of 17, 76.5%) than in asymptomatic plaques (2 of 17, 11.8%; P < .001). Interobserver and intraobserver variability with OCT diagnosis was excellent for thrombus, ulceration, neovascularization, and lipid pool.
  
  
  CONCLUSIONS
  The present findings suggest that OCT can safely and precisely visualize human carotid plaques during CAS and that intraluminal thrombus and neovascularization are more frequently detected in symptomatic plaques.
authors: Department of Neurosurgery, Graduate School of Medicine, Gifu University, Gifu, Japan. shinichiyoshimura@hotmail.com
authors: S
authors: S
authors: Yoshimura
authors: M
authors: M
authors: Kawasaki
authors: K
authors: K
authors: Yamada
authors: Y
authors: Y
authors: Enomoto
authors: Y
authors: Y
authors: Egashira
authors: A
authors: A
authors: Hattori
authors: K
authors: K
authors: Nishigaki
authors: S
authors: S
authors: Minatoguchi
authors: T
authors: T
authors: Iwama
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D058070:Asymptomatic Diseases; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging* / Q000473:pathology*; D016893:Carotid Stenosis / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000175:diagnosis*; D041623:Tomography, Optical Coherence; D018084:Ultrasonography, Interventional