Serial Assessment of Tissue Precursors and Progression of Coronary Calcification Analyzed by Fusion of IVUS and OCT: 5-Year Follow-Up of Scaffolded and Nonscaffolded Arteries.
The aim of this study was to assess calcium growth with fused grayscale intravascular ultrasound (IVUS), IVUS-virtual histology, and optical coherence tomography (OCT) from baseline to 5-year follow-up in patients treated with bioresorbable vascular scaffolds.



IVUS and OCT have individual strengths in assessing plaque composition and volume. Fusion of images obtained using these methods could potentially aid in coronary plaque assessment.



Anatomic landmarks and endoluminal radiopaque markers were used to fuse OCT and IVUS images and match baseline and follow-up.



Seventy-two IVUS-virtual histology and OCT paired matched cross-sectional in- and out-scaffold segments were fused at baseline and follow-up. In total, 46 calcified plaques at follow-up were detected using the fusion method (33 in-scaffold, 13 out-scaffold), showing either calcium progression (52.2%) or de novo calcifications (47.8%). On OCT, calcification volume increased from baseline to follow-up by 2.3 ± 2.4 mm3(p = 0.001). The baseline virtual histologic tissue precursors of dense calcium at follow-up were necrotic core in 73.9% and fibrous or fibrofatty plaque in 10.9%. In 15.2%, calcium was already present at baseline. Precursors on OCT were lipid pool in 71.2%, fibrous plaque in 4.3%, and fibrocalcific plaque in 23.9%.



The use of OCT and IVUS fusion imaging shows similar calcium growth in- and out-scaffold segments. Necrotic core is the most frequent precursor of calcification. The scaffold resorption process creates a tissue layer that re-caps the calcified plaques. (Absorb Clinical Investigation, Cohort B [ABSORB B]; NCT00856856).
ThoraxCentre, Erasmus Medical Center, Rotterdam, the Netherlands; The Emergency & Critical Care Center of Beijing Anzhen Hospital, Capital Medical University, Beijing, the People's Republic of China.
Yaping
Y
Zeng
ThoraxCentre, Erasmus Medical Center, Rotterdam, the Netherlands.
Hiroki
H
Tateishi
ThoraxCentre, Erasmus Medical Center, Rotterdam, the Netherlands.
Rafael
R
Cavalcante
ThoraxCentre, Erasmus Medical Center, Rotterdam, the Netherlands.
Erhan
E
Tenekecioglu
ThoraxCentre, Erasmus Medical Center, Rotterdam, the Netherlands; Academic Medical Center, Amsterdam, the Netherlands.
Pannipa
P
Suwannasom
Academic Medical Center, Amsterdam, the Netherlands.
Yohei
Y
Sotomi
Academic Medical Center, Amsterdam, the Netherlands.
Carlos
C
Collet
The Emergency & Critical Care Center of Beijing Anzhen Hospital, Capital Medical University, Beijing, the People's Republic of China.
Shaoping
S
Nie
Cardialysis BV, Rotterdam, the Netherlands.
Hans
H
Jonker
Division of Image Processing, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands.
Jouke
J
Dijkstra
ThoraxCentre, Erasmus Medical Center, Rotterdam, the Netherlands; Department of Cardiology, Rigshospitalet, Copenhagen, Denmark.
Maria D
MD
Radu
ThoraxCentre, Erasmus Medical Center, Rotterdam, the Netherlands; Department of Cardiology, Bern University Hospital, Bern, Switzerland.
Lorenz
L
Räber
Department of Cardiology, Christchurch Hospital, Christchurch, New Zealand.
Dougal R
DR
McClean
ThoraxCentre, Erasmus Medical Center, Rotterdam, the Netherlands.
Robert-Jan
RJ
van Geuns
Department of Cardiology, Aarhus University Hospital, Skejby Hospital, Aarhus, Denmark.
Evald H
EH
Christiansen
Department of Cardiology, Swiss Cardiovascular Center, University Hospital, Bern, Switzerland.
Therese
T
Fahrni
Cardiology, Catharina Ziekenhuis, Eindhoven, the Netherlands.
Jacques
J
Koolen
ThoraxCentre, Erasmus Medical Center, Rotterdam, the Netherlands.
Yoshinobu
Y
Onuma
ThoraxCentre, Erasmus Medical Center, Rotterdam, the Netherlands.
Nico
N
Bruining
International Centre for Circulatory Health, Imperial College, London, United Kingdom. Electronic address: patrick.w.j.c.serruys@gmail.com.
Patrick W
PW
Serruys
D020341:Absorbable Implants; D000368:Aged; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000628:therapy*; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D018450:Disease Progression; D005260:Female; D005355:Fibrosis; D005500:Follow-Up Studies; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods*; D009336:Necrosis; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation*; D058226:Plaque, Atherosclerotic; D011237:Predictive Value of Tests; D013997:Time Factors; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional; D061205:Vascular Calcification / Q000000981:diagnostic imaging* / Q000628:therapy*
bioresorbable vascular scaffold; calcification; fusion