Relationship Between Thickness of Calcium on Optical Coherence Tomography and Crack Formation After Balloon Dilatation in Calcified Plaque Requiring Rotational Atherectomy

Background: Percutaneous intervention of calcified coronary lesions often requires lesion preparation with either balloon dilatation or atherectomy. We sought to evaluate the impact of lesion preparation strategy on stent expansion following preparation of severely calcified coronary lesions with modified (cutting/scoring) balloons (MB) versus rotational atherectomy (RA) and to evaluate the impact of calcium burden as assessed by optical coherence tomography (OCT) on acute stent performance. Methods: In the PREPARE-CALC trial (Comparison of Strategies to Prepare Severely Calcified Coronary Lesions), 200 patients with severely calcified coronary lesions were randomly assigned to receive either lesion preparation with MB or RA. In 122 patients, OCT was performed before lesion preparation and at the end of the procedure. The principal end point of this OCT sub-analysis was stent expansion as assessed by OCT. The key secondary end points included stent asymmetry and eccentricity. Results: The maximal calcific arc (257.5±96.7° versus 248.7±82.1°, P =0.59), thickness (1.34±0.29 versus 1.32±0.27 mm, P =0.76), and length of calcification (21.1±9.7 versus 24.0±10.9 mm, P =0.12) did not differ between the MB versus RA group. Lesion preparation with MB versus RA lead to comparable stent expansion (73.5±13.3% versus 73.1±12.2%, respectively, P =0.85). The use of RA did not have a significant impact on stent asymmetry or eccentricity compared with the use of MB. Length of calcified plaque appeared to be increased in patients with stent underexpansion, while thickness of calcified plaque was increased in patients with stent asymmetry. Target lesion revascularization at 9 months was 3.3% when MB was used and 1.6% when RA was performed ( P =0.62). Conclusions: In this OCT sub-analysis from the PREPARE-CALC trial, calcified plaque length was increased in patients with stent underexpansion, while its thickness was higher in patients with stent asymmetry, with no impact of the lesion preparation strategy. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT02502851.

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Utilization potential of intraluminal optical coherence tomography for the Eustachian tube

Scientific Reports ◽

10.1038/s41598-021-85634-3 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Hayoung Byun ◽

Yeon Hoon Kim ◽

Jingchao Xing ◽

Su-Jin Shin ◽

Seung Hwan Lee ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Eustachian Tube ◽

Balloon Dilatation ◽

Optical Coherence ◽

Cross Sectional ◽

Anatomical Structures ◽

Complex Anatomy ◽

Before And After ◽

Tubal Lumen ◽

Oct Image

AbstractImaging the Eustachian tube is challenging because of its complex anatomy and limited accessibility. This study fabricated a fiber-based optical coherence tomography (OCT) catheter and investigated its potential for assessing the Eustachian tube anatomy. A customized OCT system and an imaging catheter, termed the Eustachian OCT, were developed for visualizing the Eustachian tube. Three male swine cadaver heads were used to study OCT image acquisition and for subsequent histologic correlation. The imaging catheter was introduced through the nasopharyngeal opening and reached toward the middle ear. The OCT images were acquired from the superior to the nasopharyngeal opening before and after Eustachian tube balloon dilatation. The histological anatomy of the Eustachian tube was compared with corresponding OCT images, The new, Eustachian OCT catheter was successfully inserted in the tubal lumen without damage. Cross-sectional images of the tube were successfully obtained, and the margins of the anatomical structures including cartilage, mucosa lining, and fat could be successfully delineated. After balloon dilatation, the expansion of the cross-sectional area could be identified from the OCT images. Using the OCT technique to assess the Eustachian tube anatomy was shown to be feasible, and the fabricated OCT image catheter was determined to be suitable for Eustachian tube assessment.

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Mechanisms of Orbital Versus Rotational Atherectomy Plaque Modification in Severely Calcified Lesions Assessed by Optical Coherence Tomography

JACC Cardiovascular Interventions ◽

10.1016/j.jcin.2017.09.031 ◽

2017 ◽

Vol 10 (24) ◽

pp. 2584-2586 ◽

Cited By ~ 23

Author(s):

Myong Hwa Yamamoto ◽

Akiko Maehara ◽

Keyvan Karimi Galougahi ◽

Gary S. Mintz ◽

Yasir Parviz ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Rotational Atherectomy ◽

Optical Coherence

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The traumatic effect of balloon dilatation on neointimal hyperplasia: what we did not see before optical coherence tomography

Heart ◽

10.1136/hrt.2010.211185 ◽

2010 ◽

Vol 97 (3) ◽

pp. 265-266 ◽

Cited By ~ 1

Author(s):

A. Picchi ◽

A. Micheli ◽

U. Limbruno

Keyword(s):

Optical Coherence Tomography ◽

Balloon Dilatation ◽

Neointimal Hyperplasia ◽

Optical Coherence ◽

Traumatic Effect

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Frequency-domain optical coherence tomography evaluation of a patient with Kawasaki disease and severely calcified plaque

International Journal of Cardiology ◽

10.1016/j.ijcard.2013.11.084 ◽

2014 ◽

Vol 171 (2) ◽

pp. 281-283 ◽

Cited By ~ 3

Author(s):

Yusuke Fujino ◽

Guilherme F. Attizzani ◽

Satoko Tahara ◽

Kensuke Takagi ◽

Hiram G. Bezerra ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Kawasaki Disease ◽

Frequency Domain ◽

Optical Coherence ◽

Calcified Plaque

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Association between debulking area of rotational atherectomy and platform revolution speed—Frequency domain optical coherence tomography analysis

Catheterization and Cardiovascular Interventions ◽

10.1002/ccd.28212 ◽

2019 ◽

Vol 95 (1) ◽

Cited By ~ 3

Author(s):

Kazuki Mizutani ◽

Masahiko Hara ◽

Kazuhiro Nakao ◽

Tomohiro Yamaguchi ◽

Tsukasa Okai ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Frequency Domain ◽

Rotational Atherectomy ◽

Optical Coherence ◽

Revolution Speed ◽

Tomography Analysis

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Evaluation of Crack Formation and Propagation with Ultrasonic Root-End Preparation and Obturation Using a Digital Microscope and Optical Coherence Tomography

Scanning ◽

10.1155/2019/5240430 ◽

2019 ◽

Vol 2019 ◽

pp. 1-6

Author(s):

Bayan Rashed ◽

Yoshiko Iino ◽

Arata Ebihara ◽

Takashi Okiji

Keyword(s):

Optical Coherence Tomography ◽

Crack Formation ◽

Mineral Trioxide Aggregate ◽

Optical Coherence ◽

Micro Ct ◽

Weak Correlation ◽

Significant Difference ◽

Digital Microscope ◽

Ultrasonic Preparation ◽

End Resection

Objective. This study is aimed at determining (1) the effect of root-end resection, ultrasonic root-end preparation, and root-end filling on the incidence of crack formation and propagation by using a digital microscope (DM) and optical coherence tomography (OCT) and (2) the performance of OCT on the detection of cracks by comparing with microcomputed tomography (micro-CT) as a reference standard. Methodology. Thirty extracted lower incisors were endodontically treated and subjected to root-end resection and ultrasonic root-end cavity preparation. Then, the teeth were divided into three groups (n=10, each), and the root-end cavity was either left unfilled or filled with mineral trioxide aggregate (MTA) or super-EBA. The resected surface was observed with OCT and DM after the root-end resection, ultrasonic root-end preparation, and root-end filling, and the frequency of incomplete and complete cracks were recorded. The observation was repeated after two weeks, one month, and two months, and micro-CT scans after two months were taken as the gold standard. Results. The DM results show dentinal crack formation in 47% of the samples following root-end resection and in 87% following ultrasonic preparation. After the ultrasonic preparation, no existing crack propagated to a complete crack, but new cracks were formed. MTA and super-EBA had no effect on crack formation. The Spearman correlation coefficient between OCT and DM was 0.186 (very weak correlation; p=0.015). Sensitivity and specificity in comparison to micro-CT were 0.50 and 0.55 in OCT and 1.00 and 0.35 in DM, respectively. McNemar’s test showed a significant difference between OCT and DM (p<0.05). Conclusion. Apical resection and ultrasonic preparation could form dentinal cracks. OCT and DM showed different detection frequencies of cracks with very weak correlation. DM showed superior sensitivity compared with OCT.

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