Coronary optical frequency domain imaging (OFDI) for in vivo evaluation of stent healing: comparison with light and electron microscopy

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 p...

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Autores principales: 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
Formato: Texto
Lenguaje:English
Publicado: Oxford University Press 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2903715/
https://www.ncbi.nlm.nih.gov/pubmed/20525979
http://dx.doi.org/10.1093/eurheartj/ehq168
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author 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
author_facet 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
author_sort Templin, Christian
collection PubMed
description 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.
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spelling pubmed-29037152010-07-15 Coronary optical frequency domain imaging (OFDI) for in vivo evaluation of stent healing: comparison with light and electron microscopy 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 Eur Heart J Basic Science 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. Oxford University Press 2010-07 2010-06-05 /pmc/articles/PMC2903715/ /pubmed/20525979 http://dx.doi.org/10.1093/eurheartj/ehq168 Text en Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2010. For permissions please email: journals.permissions@oxfordjournals.org http://creativecommons.org/licenses/by-nc/2.0/uk/ The online version of this article has been published under an open access model. Users are entitled to use, reproduce, disseminate, or display the open access version of this article for non-commercial purposes provided that the original authorship is properly and fully attributed; the Journal, Learned Society and Oxford University Press are attributed as the original place of publication with correct citation details given; if an article is subsequently reproduced or disseminated not in its entirety but only in part or as a derivative work this must be clearly indicated. For commercial re-use, please contact journals.permissions@oxfordjournals.org.
spellingShingle Basic Science
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
Coronary optical frequency domain imaging (OFDI) for in vivo evaluation of stent healing: comparison with light and electron microscopy
title Coronary optical frequency domain imaging (OFDI) for in vivo evaluation of stent healing: comparison with light and electron microscopy
title_full Coronary optical frequency domain imaging (OFDI) for in vivo evaluation of stent healing: comparison with light and electron microscopy
title_fullStr Coronary optical frequency domain imaging (OFDI) for in vivo evaluation of stent healing: comparison with light and electron microscopy
title_full_unstemmed Coronary optical frequency domain imaging (OFDI) for in vivo evaluation of stent healing: comparison with light and electron microscopy
title_short Coronary optical frequency domain imaging (OFDI) for in vivo evaluation of stent healing: comparison with light and electron microscopy
title_sort coronary optical frequency domain imaging (ofdi) for in vivo evaluation of stent healing: comparison with light and electron microscopy
topic Basic Science
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2903715/
https://www.ncbi.nlm.nih.gov/pubmed/20525979
http://dx.doi.org/10.1093/eurheartj/ehq168
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