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(Circulation. 2001;104:2754.)
© 2001 American Heart Association, Inc.

Images in Cardiovascular Medicine

Visualization of Tissue Prolapse Between Coronary Stent Struts by Optical Coherence Tomography

Comparison With Intravascular Ultrasound

Ik-Kyung Jang, MD; Guillermo Tearney, MD, PhD; Brett Bouma, PhD

From Massachusetts General Hospital, Harvard Medical School, Boston, Mass.

Correspondence to Ik-Kyung Jang, MD, Cardiology Division, Bulfinch 105, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114. E-mail ijang@partners.org

A 65-year-old man underwent cardiac catheterization for unstable angina pectoris. The coronary angiogram revealed a significant stenosis of the right coronary artery, which was treated with a 3.0x16 mm NIR stent. A postintervention coronary angiogram showed excellent results, and intravascular ultrasound (IVUS; 30 MHz, Ultracross, Boston Scientific) showed a well-deployed stent (Figure, A). A 3.2 F optical coherence tomography (OCT) catheter, advanced to the same site, showed well-apposed stent struts (Figure, B). In addition, tissue prolapse between the stent struts (12 to 3 o’clock in B) was clearly visualized. The tissue prolapse occurred mainly in an area with a lower OCT signal intensity (vessel wall visualized between the stent struts), which is suggestive of a plaque with decreased collagen content. A retrospective review of the IVUS study showed an area of possible tissue prolapse at the corresponding location (1 o’clock in A).

View larger version (99K): [in this window] [in a new window]   IVUS (A) and OCT (B) images of the stented right coronary artery are shown. Although IVUS showed a well-deployed stent, the detailed structure around the stent struts is not well visualized. In addition, OCT clearly visualized tissue prolapse between the stent struts (12 to 3 o’clock). The tissue prolapse occurred mainly in an area with lower OCT signal intensity, which is suggestive of a plaque with a large lipid content.

OCT is an optical analog of IVUS with a high resolution (10 µm versus 100 µm of IVUS). Recently, our laboratory developed a catheter-based intracoronary OCT system. The OCT image(Figure, . . . [Full Text of this Article]

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