External elastic lamina vs. luminal diameter measurement for determining stent diameter by optical coherence tomography: an ILUMIEN III substudy

2020 ◽  
Author(s):  
Evan Shlofmitz ◽  
Allen Jeremias ◽  
Yasir Parviz ◽  
Keyvan Karimi Galougahi ◽  
Björn Redfors ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Correction Factor ◽  
Vessel Diameter ◽  
Optical Coherence ◽  
Diameter Measurement ◽  
Luminal Diameter ◽  
Stent Diameter ◽  
Vessel Diameter Measurement ◽  
Elastic Lamina ◽  
Selection Of

Abstract Aims Optical coherence tomography (OCT)-guided external elastic lamina (EEL)-based stent sizing is safe and as effective as intravascular ultrasound in achieving post-procedural lumen dimensions. However, when compared with automated lumen diameter (LD) measurements, this approach is time-consuming. We aimed to compare vessel diameter measurements and stent diameter selection using either of these approaches and examined whether applying a correction factor to automated LD measurements could result in selecting similar stent diameters to the EEL-based approach. Methods and results We retrospectively compared EEL-based measurements vs. automated LD in reference segments in 154 OCT acquisitions and derived a correction factor for stent sizing using the ratio of EEL to LD measurements. We then prospectively applied the correction factor in 119 OCT acquisitions. EEL could be adequately identified in 100 acquisitions (84%) at the distal reference to allow vessel diameter measurement. Vessel diameters were larger with EEL-based vs. LD measurements at both proximal (4.12 ± 0.74 vs. 3.14 ± 0.67 mm, P < 0.0001) and distal reference segments (3.34 ± 0.75 vs. 2.64 ± 0.65 mm, P < 0.0001). EEL-based downsizing led to selection of larger stents vs. an LD-based upsizing approach (3.33 ± 0.47 vs. 2.70 ± 0.44, P < 0.0001). Application of correction factors to LD [proximal 1.32 (IQR 1.23–1.37) and distal 1.25 (IQR 1.19–1.36)] resulted in discordance in stent sizing by >0.25 mm in 63% and potentially hazardous stent oversizing in 41% of cases. Conclusion EEL-based stent downsizing led to selection of larger stent diameters vs. LD upsizing. While applying a correction factor to automated LD measurements resulted in similar mean diameters to EEL-based measurements, this approach cannot be used clinically due to frequent and potentially hazardous stent over-sizing.

scholarly journals TCT-297 External elastic lamina vs luminal diameter for determination of stent diameter by optical coherence tomography

2017 ◽  
Vol 70 (18) ◽  
pp. B121-B122
Author(s):  
Yasir Parviz ◽  
Evan Shlofmitz ◽  
Bjorn Redfors ◽  
Mitsuaki Matsumura ◽  
Akiko Maehara ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Optical Coherence ◽  
Luminal Diameter ◽  
Stent Diameter ◽  
Elastic Lamina

Choice of Intracoronary Imaging: When to Use Intravascular Ultrasound or Optical Coherence Tomography

2016 ◽  
Vol 11 (1) ◽  
pp. 11
Author(s):  
Sudheer Koganti ◽  
◽  
◽  
◽  
Tushar Kotecha ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Coronary Angiography ◽  
Intravascular Ultrasound ◽  
Coronary Stenosis ◽  
Coronary Intervention ◽  
Vessel Diameter ◽  
Drug Eluting Stent ◽  
Optical Coherence ◽  
Disease Extent ◽  
Intracoronary Imaging

Intracoronary imaging has the capability of accurately measuring vessel and stenosis dimensions, assessing vessel integrity, characterising lesion morphology and guiding optimal percutaneous coronary intervention (PCI). Coronary angiography used to detect and assess coronary stenosis severity has limitations. The 2D nature of fluoroscopic imaging provides lumen profile only and the assessment of coronary stenosis by visual estimation is subjective and prone to error. Performing PCI based on coronary angiography alone is inadequate for determining key metrics of the vessel such as dimension, extent of disease, and plaque distribution and composition. The advent of intracoronary imaging has offset the limitations of angiography and has shifted the paradigm to allow a detailed, objective appreciation of disease extent and morphology, vessel diameter, stent size and deployment and healing after PCI. It has become an essential tool in complex PCI, including rotational atherectomy, in follow-up of novel drug-eluting stent platforms and understanding the pathophysiology of stent failure after PCI (e.g. following stent thrombosis or in-stent restenosis). In this review we look at the two currently available and commonly used intracoronary imaging tools – intravascular ultrasound and optical coherence tomography – and the merits of each.

Neointimal Healing Evaluated by Optical Coherence Tomography after Drug-Eluting Absorbable Metal Scaffold Implantation in de novo Native Coronary Lesions: Rationale and Design of the Magmaris-OCT Study

Cardiology ◽  
2017 ◽  
Vol 137 (4) ◽  
pp. 225-230 ◽  
Author(s):  
Pasi Karjalainen ◽  
Tuomas Paana ◽  
Jussi Sia ◽  
Wail Nammas
Keyword(s):  
Optical Coherence Tomography ◽  
De Novo ◽  
Quantitative Coronary Angiography ◽  
Vessel Diameter ◽  
Target Lesion ◽  
Lesion Length ◽  
Optical Coherence ◽  
Flow Reserve ◽  
Coronary Lesions

Objectives: We sought to explore neointimal healing assessed by optical coherence tomography (OCT) following implantation of the Magmaris sirolimus-eluting absorbable metal scaffold. Methods: The Magmaris-OCT is a prospective, multicenter, single-arm observational clinical study, intended to enrol 60 consecutive patients with up to 2 de novo native coronary lesions, each located in different major epicardial vessels, with a reference vessel diameter of 2.5-3.5 mm, and a maximum lesion length of 20 mm. Patients will undergo Magmaris scaffold implantation in the target lesion, according to the standard practice. Clinical follow-up will take place at 30 days, and at 3, 6, 9, and 12 months. For invasive-imaging follow-up, patients will be classified into 3 groups: cohort A will be scheduled for follow-up at 3 months, cohort B at 6 months, and cohort C at 12 months. Invasive imaging will include quantitative coronary angiography, OCT evaluation, and coronary flow reserve measurement. The primary end point will be the percentage of uncovered scaffold struts assessed by OCT at the prespecified follow-up. Conclusions: This study will provide insight into the short- and mid-term healing properties following Magmaris scaffold implantation, with special emphasis on the neointimal coverage of scaffold struts.

Relation between retinal vessel diameter and posterior segment optical coherence tomography variables in middle-aged Caucasians: the Northern Finland Birth Cohort Eye Study

2020 ◽  
Vol 104 (10) ◽  
pp. 1435-1442
Author(s):  
Mohamed I Geneid ◽  
Janne J Uusitalo ◽  
Ilmari L Leiviskä ◽  
Ville O Saarela ◽  
M Johanna Liinamaa
Keyword(s):  
Optical Coherence Tomography ◽  
Optic Nerve ◽  
Retinal Vessel ◽  
Vessel Diameter ◽  
Macular Thickness ◽  
Optical Coherence ◽  
Middle Aged ◽  
Macular Volume ◽  
Rnfl Thickness ◽  
Arteriolar Diameter

AimsStudying the relationship between retinal vessel diameter (RVD) with (1) macular thickness and volume, (2) retinal nerve fibre layer (RNFL), (3) ganglion cell-inner plexiform layer (GC-IPL) and (4) optic nerve head (ONH) in a population cohort of middle-aged Caucasians.MethodsWe collected data from 3070 individuals. We used a semiautomated computer-assisted programme to measure central retinal arteriolar equivalent and central retinal venular equivalent. Macular and ONH parameters were assessed by optical coherence tomography.ResultsData from 2155 persons were analysed. A larger RVD was associated with a thicker macula and increased macular volume; each SD increase in average macular thickness and volume was associated with a 3.28 µm and a 3.19 µm increase in arteriolar diameter and a 5.10 µm and a 5.08 µm increase in venular diameter, respectively (p<0.001 for all). A larger rim area, greater GC-IPL and RNFL thicknesses were associated with larger RVD; each SD increase in rim area, GC-IPL thickness and RNFL thickness was associated with a 1.21 µm, 2.68 µm and a 3.29 µm increase in arteriolar diameter and a 2.13 µm, 4.02 µm and 5.04 µm increase in venular diameter, respectively (p<0.001 for all).ConclusionsIncreased macular thickness, macular volume, GC-IPL thickness, RNFL thickness and optic nerve rim area were associated with larger RVDs in all subjects. This study clarified the anatomical correlations between both macular and ONH parameters with RVD for middle-aged Caucasians; these can represent a basis for further studies investigating the vascular aetiology of eye diseases.

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