Abstract 18893: Poly-L-Lactide Bioresorbable Vascular Scaffold Disruption as Assessed in vivo by Three-Dimensional ECG-Triggered Ultrahigh-Speed OCT and Its Detrimental Effects on Arterial Healing
Background: While bioresorbable vascular scaffold (BVS) disruption is known to predispose to thrombosis, current 2 dimensional-optical coherence tomography (2D-OCT) may not fully characterize scaffold configuration in a beating coronary artery. This study aimed to assess the usefulness of a novel 3D ECG-triggered ultrahigh-speed OCT (3D-UHS-OCT) to estimate BVS disruption, and to investigate the impact of disrupted scaffold on arterial healing.
Methods and Results: After BVSs implantation in swine coronary arteries, scaffold disruption was induced by balloon over-expansion. BVS integrity and neointimal formation were serially assessed in vivo by both our 3D ECG-triggered UHS-OCT (500rps, pullback-speed 100 mm/sec) and clinical 2D OCT (100rps, pullback-speed 20 mm/sec). To estimate BVS-associated arterial inflammation, OCT-NIRF (near-infrared fluorescence) molecular imaging was performed using indocyanine green as a macrophage-targeting fluorophore. After in vivo imagings, resected BVS segments were examined for structural integrity. Acute disruption was determined based on current 2D-OCT criteria or the presence of gap along arbitrary 3D strut map scaffold line of UHS-OCT. Despite multiple widespread disruptions of BVS architecture on 3D-UHS-OCT, stacked/overhung/isolated struts were found only in a small fraction (12.4%) of 2D-OCT imagings. Intriguingly, disruptions around interconnecting hinges were not discernible with 2D-OCT. Sensitivity and specificity for disrupted scaffold detection by 3D-UHS-OCT were much higher as compared to 2D-OCT(p<0.01). By serial OCT-NIRF imaging, BVS disruption was significantly associated with arterial inflammation, leading to delayed strut coverage.
Conclusions: 3D ECG-tirggered UHS-OCT was able to assess BVS conformational changes more accurately than conventional 2D-OCT. Our novel motion free 3D-UHS-OCT is expected to provide new opportunity for optimal BVS implantation.
- Bioabsorbable stents
- Cardiovascular imaging
- Percutaneous coronary intervention (PCI)
Author Disclosures: S. Kim: None. H. Park: None. M. Lee: None. T. Kim: None. W. Kim: None. H. Nam: None. J. Song: None. D. Oh: None. K. Park: None. H. Yoo: None. W. Oh: None. J. Kim: None.
- © 2016 by American Heart Association, Inc.