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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{at}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, B) was acquired during the first application of this technology in humans. This new imaging modality may be useful in improving the outcome of coronary intervention and may also help identify vulnerable coronary plaques.

Footnotes

The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St. Luke's Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.

Circulation encourages readers to submit cardiovascular images to the Circulation Editorial Office, St. Luke’s Episcopal Hospital/Texas Heart Institute, 6720 Bertner Ave, MC1-267, Houston, TX 77030.

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This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Jang, I.-K. Articles by Bouma, B. Search for Related Content PubMed PubMed Citation Articles by Jang, I.-K. Articles by Bouma, B. Related Collections Catheter-based coronary interventions: stents Cardiovascular imaging agents/Techniques Coronary imaging: angiography/ultrasound/Doppler/CC