Abstract 14756: Comparison of Angioscope and Optical Coherence Tomography findings for the Assessment of Intra-stent Thrombus and Neointima at 8 months After Sirolimus-Eluting Stent Implantation.
Background: Angioscopy has a superiority of qualitative full color visualization of neointima and thrombus, while optical coherence tomography (OCT) has an advantage for quantitative measurement.
Objective: The purpose of this study was to compare angioscopic findings with OCT in the assessment of neointima and thrombus after sirolimus-eluting stent (SES) implantation.
Method: 21 patients with stable angina who underwent SES implantation (n=26, 53 segments) were examined by angioscope and OCT at 8 month post-implant. By angioscope, we assessed dominant neointimal coverage (NI grade 0: uncovered to 3: covered invisible), color of neointima (yellow neointima (YN) or white neointima (WN)) and mural red thrombus (MTa grade 0: none, 1: focal/peri-strut, 2: extended) within the stent segmentally. By OCT, neointimal thickness (NIT), frequency of thrombus (MTo as a protruding mass with OCT attenuation) and signal intensity index of neointima (SI index: defined as the signal mean intensity of neointima divided by the average signal mean intensity of normal intima) was measured.
Result: Distribution of angioscopic NI grade was as 0: 8%, 1: 58%, 2: 17%, 3: 17%. Mean NIT stepwisely increased according to NI grade (grade 0: 28±44μm, 1: 57±24μm, 2: 100±79μm, 3: 210±119μm). Angioscopic YN was observed in 66% (35/53). MTa grade was higher at low NI grade than at high NI grade (0,1: 1.4±0.5, 2,3: 1.0), and also higher at YN than that at WN (1.7±0.5 vs. 1.0±0.0, p=0.02). OCT sometimes failed to detect ‘non-protruding’ mural thrombus within YN (Figure). However, SI index of YN was lower than that of WN (0.92±0.05 vs. 0.97±0.04, p=0.004). All of SI index at WN without MTa was more than 0.91.
Conclusion: Angioscopic YN and low NI grade was prone to thrombus formation. Measurement of OCT signal intensity may help to assess neointima and thrombus qualitatively and quantitatively after stent implantation.
- © 2011 by American Heart Association, Inc.