Coronary optical frequency domain imaging (OFDI) for in vivo evaluation of stent healing: comparison with light and electron microscopy
| Autor: | Simon P. Hoerstrup, Valentin Djonov, Martin Meyer, Karina Klein, Peter W Kronen, Maja Müller, Roberto Corti, Christian Templin, Thomas F. Lüscher, Dragica Paunovic, Flora Nicholls, Michèle Sidler, Jelena-Rima Ghadri, Ruslan Hlushchuk, Ulf Landmesser, Klaus Weber, Stefanie Flueckiger, Ivanka Dimova |
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| Přispěvatelé: | University of Zurich, Templin, C |
| Jazyk: | angličtina |
| Rok vydání: | 2010 |
| Předmět: |
Swine
medicine.medical_treatment law.invention Basic Science law Intravascular ultrasound Medicine 10239 Institute of Laboratory Animal Science Optical frequency domain imaging 610 Medicine & health Microscopy medicine.diagnostic_test biology Graft Occlusion Vascular Coronary Vessels Prosthesis Failure surgical procedures operative 10209 Clinic for Cardiology Stents Tomography Radiology Cardiology and Cardiovascular Medicine Tomography Optical Coherence medicine.medical_specialty Fibrin 2705 Cardiology and Cardiovascular Medicine Stent strut coverage Optical coherence tomography In vivo Coronary stent Animals cardiovascular diseases Wound Healing 11077 Center for Applied Biotechnology and Molecular Medicine business.industry Stent equipment and supplies Histological validation 10020 Clinic for Cardiac Surgery 10022 Division of Surgical Research ROC Curve biology.protein Microscopy Electron Scanning 570 Life sciences 10090 Equine Department Electron microscope business Biomedical engineering |
| Zdroj: | European Heart Journal Templin, Christian; Meyer, Martin; Müller, Maja Franziska; Djonov, Valentin; Hlushchuk, Ruslan; Dimova, Ivanka; Flueckiger, Stefanie; Kronen, Peter; Sidler, Michele; Klein, Karina; Nicholls, Flora; Ghadri, Jelena-Rima; Weber, Klaus; Paunovic, Dragica; Corti, Roberto; Hoerstrup, Simon P; Lüscher, Thomas F; Landmesser, Ulf (2010). Coronary optical frequency domain imaging (OFDI) for in vivo evaluation of stent healing: comparison with light and electron microscopy. European Heart Journal, 31(14), pp. 1792-801. Oxford: Oxford University Press 10.1093/eurheartj/ehq168 |
| ISSN: | 1522-9645 0195-668X |
| DOI: | 10.1093/eurheartj/ehq168 |
| Popis: | Aims Coronary late stent thrombosis, a rare but devastating complication, remains an important concern in particular with the increasing use of drug-eluting stents. Notably, pathological studies have indicated that the proportion of uncovered coronary stent struts represents the best morphometric predictor of late stent thrombosis. Intracoronary optical frequency domain imaging (OFDI), a novel second-generation optical coherence tomography (OCT)-derived imaging method, may allow rapid imaging for the detection of coronary stent strut coverage with a markedly higher precision when compared with intravascular ultrasound, due to a microscopic resolution (axial ∼10–20 µm), and at a substantially increased speed of image acquisition when compared with first-generation time-domain OCT. However, a histological validation of coronary OFDI for the evaluation of stent strut coverage in vivo is urgently needed. Hence, the present study was designed to evaluate the capacity of coronary OFDI by electron (SEM) and light microscopy (LM) analysis to detect and evaluate stent strut coverage in a porcine model. Methods and results Twenty stents were implanted into 10 pigs and coronary OFDI was performed after 1, 3, 10, 14, and 28 days. Neointimal thickness as detected by OFDI correlated closely with neointimal thickness as measured by LM ( r = 0.90, P < 0.01). The comparison of stent strut coverage as detected by OFDI and SEM analysis revealed an excellent agreement ( r = 0.96, P < 0.01). In particular, stents completely covered by OFDI analysis were also completely covered by SEM analysis. All incompletely covered stents by OFDI were also incompletely covered by SEM. Analyses of fibrin-covered stent struts suggested that these may rarely be detected as uncovered stent struts by OFDI. Importantly, optical density measurements revealed a significant difference between fibrin- and neointima-covered coronary stent struts [0.395 (0.35–0.43) vs. 0.53 (0.47–0.57); P < 0.001], suggesting that differences in optical density provide information on the type of stent strut coverage. The sensitivity and specificity for detection of fibrin vs. neointimal coverage was evaluated using receiver-operating characteristic analysis. Conclusion The present study demonstrates that OFDI is a highly promising tool for accurate evaluation of coronary stent strut coverage, as supported by a high agreement between OFDI and light and electron microscopic analysis. Furthermore, our data indicate that optical density measurements can provide additional information with respect to the type of stent strut coverage, i.e. fibrin vs. neointimal coverage. Therefore, coronary OFDI analysis will provide important information on the biocompatibility of coronary stents. |
| Databáze: | OpenAIRE |
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