The Effect of Stent Artefact on Quantification of Plaque Features Using Optical Coherence Tomography (OCT): A Feasibility and Clinical Utility Study

Kamran Majeed, Eline Hartman, Trevor A Mori, Richard Alcock, Jon Spiro, Jurgen Ligthart, Karen Witberg, Graham Hillis, Gijs van Soest, Carl Schultz

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Optical coherence tomography (OCT) can detect detailed plaque features in native coronary arteries. Stent struts cause shadows that partially obscure the vessel wall, but plaque features can still be seen. We investigated the impact of stent artefact on plaque quantification and whether the plaque behind struts is associated with microvascular dysfunction.

METHODS: Patients retrospectively recruited from two centres, underwent OCT pre- and post-stenting on the same vessel segment. Lipid (LA) and calcium (CA) were measured as arcs. Macrophages, microchannels and cholesterol crystals were counted. Subsequently, we determined whether stented plaque features were associated with reduced TIMI flow grade in consecutive patients who underwent OCT post-stenting.

RESULTS: In 52 patients the lipid arc was similar pre- vs post-stent: median (55º [13º-93º] vs. 40º [18º-87°]; difference 1º [-7º to 16º], p = NS). Pre- and post-stent lipid were strongly correlated (r = 0.92, p < 0.001). In a further 128 patients those with reduced (TIMI ≤ II) vs normal flow post percutaneous coronary intervention (PCI) showed more plaque behind struts: lipid (89º [50º-139º] vs 62º [29º-88°]; p < 0.001); and calcium (24º [6º-45º] vs 7° [0º-34º]; p = 0.031). Multivariate logistic regression analysis showed that abnormal TIMI flow post-stenting was associated with diabetes (Odds ratio [OR] 2.87, CI 1.01-8.19, p = 0.048), LA (OR 1.29, 95% CI 1.14-1.38, p < 0.001) and CA (OR 1.26, CI 1,07-1.40, p = 0.005).

CONCLUSIONS: Plaque behind the struts can be accurately quantified using OCT. Furthermore, OCT plaque features in stented segments are associated with microvascular dysfunction post PCI.

Original languageEnglish
JournalHeart, Lung & Circulation
DOIs
Publication statusE-pub ahead of print - 4 Jul 2019

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Optical Coherence Tomography
Artifacts
Stents
Lipids
Odds Ratio
Percutaneous Coronary Intervention
Calcium
Coronary Vessels
Logistic Models
Macrophages
Cholesterol
Regression Analysis
Clinical Studies

Cite this

@article{4cb94efcd9f74788ad0f213eddca63c2,
title = "The Effect of Stent Artefact on Quantification of Plaque Features Using Optical Coherence Tomography (OCT): A Feasibility and Clinical Utility Study",
abstract = "BACKGROUND: Optical coherence tomography (OCT) can detect detailed plaque features in native coronary arteries. Stent struts cause shadows that partially obscure the vessel wall, but plaque features can still be seen. We investigated the impact of stent artefact on plaque quantification and whether the plaque behind struts is associated with microvascular dysfunction.METHODS: Patients retrospectively recruited from two centres, underwent OCT pre- and post-stenting on the same vessel segment. Lipid (LA) and calcium (CA) were measured as arcs. Macrophages, microchannels and cholesterol crystals were counted. Subsequently, we determined whether stented plaque features were associated with reduced TIMI flow grade in consecutive patients who underwent OCT post-stenting.RESULTS: In 52 patients the lipid arc was similar pre- vs post-stent: median (55º [13º-93º] vs. 40º [18º-87°]; difference 1º [-7º to 16º], p = NS). Pre- and post-stent lipid were strongly correlated (r = 0.92, p < 0.001). In a further 128 patients those with reduced (TIMI ≤ II) vs normal flow post percutaneous coronary intervention (PCI) showed more plaque behind struts: lipid (89º [50º-139º] vs 62º [29º-88°]; p < 0.001); and calcium (24º [6º-45º] vs 7° [0º-34º]; p = 0.031). Multivariate logistic regression analysis showed that abnormal TIMI flow post-stenting was associated with diabetes (Odds ratio [OR] 2.87, CI 1.01-8.19, p = 0.048), LA (OR 1.29, 95{\%} CI 1.14-1.38, p < 0.001) and CA (OR 1.26, CI 1,07-1.40, p = 0.005).CONCLUSIONS: Plaque behind the struts can be accurately quantified using OCT. Furthermore, OCT plaque features in stented segments are associated with microvascular dysfunction post PCI.",
author = "Kamran Majeed and Eline Hartman and Mori, {Trevor A} and Richard Alcock and Jon Spiro and Jurgen Ligthart and Karen Witberg and Graham Hillis and {van Soest}, Gijs and Carl Schultz",
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month = "7",
day = "4",
doi = "10.1016/j.hlc.2019.05.182",
language = "English",
journal = "Heart, Lung & Circulation",
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The Effect of Stent Artefact on Quantification of Plaque Features Using Optical Coherence Tomography (OCT) : A Feasibility and Clinical Utility Study. / Majeed, Kamran; Hartman, Eline; Mori, Trevor A; Alcock, Richard; Spiro, Jon; Ligthart, Jurgen; Witberg, Karen; Hillis, Graham; van Soest, Gijs; Schultz, Carl.

In: Heart, Lung & Circulation, 04.07.2019.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The Effect of Stent Artefact on Quantification of Plaque Features Using Optical Coherence Tomography (OCT)

T2 - A Feasibility and Clinical Utility Study

AU - Majeed, Kamran

AU - Hartman, Eline

AU - Mori, Trevor A

AU - Alcock, Richard

AU - Spiro, Jon

AU - Ligthart, Jurgen

AU - Witberg, Karen

AU - Hillis, Graham

AU - van Soest, Gijs

AU - Schultz, Carl

PY - 2019/7/4

Y1 - 2019/7/4

N2 - BACKGROUND: Optical coherence tomography (OCT) can detect detailed plaque features in native coronary arteries. Stent struts cause shadows that partially obscure the vessel wall, but plaque features can still be seen. We investigated the impact of stent artefact on plaque quantification and whether the plaque behind struts is associated with microvascular dysfunction.METHODS: Patients retrospectively recruited from two centres, underwent OCT pre- and post-stenting on the same vessel segment. Lipid (LA) and calcium (CA) were measured as arcs. Macrophages, microchannels and cholesterol crystals were counted. Subsequently, we determined whether stented plaque features were associated with reduced TIMI flow grade in consecutive patients who underwent OCT post-stenting.RESULTS: In 52 patients the lipid arc was similar pre- vs post-stent: median (55º [13º-93º] vs. 40º [18º-87°]; difference 1º [-7º to 16º], p = NS). Pre- and post-stent lipid were strongly correlated (r = 0.92, p < 0.001). In a further 128 patients those with reduced (TIMI ≤ II) vs normal flow post percutaneous coronary intervention (PCI) showed more plaque behind struts: lipid (89º [50º-139º] vs 62º [29º-88°]; p < 0.001); and calcium (24º [6º-45º] vs 7° [0º-34º]; p = 0.031). Multivariate logistic regression analysis showed that abnormal TIMI flow post-stenting was associated with diabetes (Odds ratio [OR] 2.87, CI 1.01-8.19, p = 0.048), LA (OR 1.29, 95% CI 1.14-1.38, p < 0.001) and CA (OR 1.26, CI 1,07-1.40, p = 0.005).CONCLUSIONS: Plaque behind the struts can be accurately quantified using OCT. Furthermore, OCT plaque features in stented segments are associated with microvascular dysfunction post PCI.

AB - BACKGROUND: Optical coherence tomography (OCT) can detect detailed plaque features in native coronary arteries. Stent struts cause shadows that partially obscure the vessel wall, but plaque features can still be seen. We investigated the impact of stent artefact on plaque quantification and whether the plaque behind struts is associated with microvascular dysfunction.METHODS: Patients retrospectively recruited from two centres, underwent OCT pre- and post-stenting on the same vessel segment. Lipid (LA) and calcium (CA) were measured as arcs. Macrophages, microchannels and cholesterol crystals were counted. Subsequently, we determined whether stented plaque features were associated with reduced TIMI flow grade in consecutive patients who underwent OCT post-stenting.RESULTS: In 52 patients the lipid arc was similar pre- vs post-stent: median (55º [13º-93º] vs. 40º [18º-87°]; difference 1º [-7º to 16º], p = NS). Pre- and post-stent lipid were strongly correlated (r = 0.92, p < 0.001). In a further 128 patients those with reduced (TIMI ≤ II) vs normal flow post percutaneous coronary intervention (PCI) showed more plaque behind struts: lipid (89º [50º-139º] vs 62º [29º-88°]; p < 0.001); and calcium (24º [6º-45º] vs 7° [0º-34º]; p = 0.031). Multivariate logistic regression analysis showed that abnormal TIMI flow post-stenting was associated with diabetes (Odds ratio [OR] 2.87, CI 1.01-8.19, p = 0.048), LA (OR 1.29, 95% CI 1.14-1.38, p < 0.001) and CA (OR 1.26, CI 1,07-1.40, p = 0.005).CONCLUSIONS: Plaque behind the struts can be accurately quantified using OCT. Furthermore, OCT plaque features in stented segments are associated with microvascular dysfunction post PCI.

U2 - 10.1016/j.hlc.2019.05.182

DO - 10.1016/j.hlc.2019.05.182

M3 - Article

JO - Heart, Lung & Circulation

JF - Heart, Lung & Circulation

SN - 1444-2892

ER -