scholarly journals First-in-Human Cutting Balloon Broken Blade Fracture Imaged Using Optical Frequency Domain Imaging/High-Definition Intravascular Ultrasound

2020 ◽  
Vol 13 (14) ◽  
pp. 1718-1719
Author(s):  
Umihiko Kaneko ◽  
Yoshifumi Kashima ◽  
Daitaro Kanno ◽  
Tsutomu Fujita
Keyword(s):  
Frequency Domain ◽  
Intravascular Ultrasound ◽  
Optical Frequency ◽  
High Definition ◽  
Cutting Balloon ◽  
Optical Frequency Domain Imaging

scholarly journals High-Definition Intravascular Ultrasound Versus Optical Frequency Domain Imaging for the Detection of Calcium Modification and Fracture in Heavily Calcified Coronary Lesion

2021 ◽  
Author(s):  
Masaru Ishida ◽  
Yuya Oshikiri ◽  
Takumi Kimura ◽  
Ryohei Sakamoto ◽  
Yudai Shimoda ◽  
...  
Keyword(s):  
Frequency Domain ◽  
Intravascular Ultrasound ◽  
Guide Wire ◽  
Optical Frequency ◽  
High Definition ◽  
Predictive Values ◽  
Optical Frequency Domain Imaging ◽  
Coronary Lesions ◽  
Calcium Modification ◽  
Calcified Coronary Lesions

Abstract Purpose While optical frequency domain imaging (OFDI) can delineate calcium modification and fracture, the capability of high-definition intravascular ultrasound (HD-IVUS) for detecting these remains unclear. This study evaluated the diagnostic accuracy of HD-IVUS for assessing calcium modification and fracture as compared to OFDI. Methods HD-IVUS and OFDI were used during orbital or rotational atherectomy procedures conducted for 21 heavily calcified coronary lesions in 19 patients. With OFDI assessment used as the gold standard, diagnostic accuracies of HD-IVUS for calcium modification and fracture were compared every 1 mm to the matched pre-stenting images (n=1,129). Calcium modification, as assessed by OFDI, was defined as polished and concave-shaped calcium. For HD-IVUS, calcium modification was defined as the presence of reverberation with concave-shaped calcium. In both assessments, the definition of calcium fracture was defined as a slit or complete break in the calcium plate. Results Calcified plaque was found in 86.4% of analyzed OFDI images. Calcium modification and fracture were detected in 20.6% and 11.0% of detected calcified plaques. Sensitivity, specificity, positive and negative predictive values of HD-IVUS detection for calcium modification and fracture were 54.4%, 97.8%, 86.7%, 89.1% and 86.0%, 94.5%, 58.2%, 96.8%, respectively. Discordance cases between both assessments demonstrated that heterogeneous calcium visualized by OFDI, separated calcium and guide wire artifact can be misdiagnosed. Conclusion Diagnostic accuracies of HD-IVUS for assessing calcium modification and fracture were modest as compared to OFDI. These results suggest that OFDI guidance is more feasible during treatment of heavily calcified coronary lesions versus HD-IVUS guidance.

scholarly journals Comparison Between Optical Frequency Domain Imaging and Intravascular Ultrasound for Percutaneous Coronary Intervention Guidance in Biolimus A9-Eluting Stent Implantation

2020 ◽  
Vol 13 (11) ◽  
Author(s):  
Takashi Muramatsu ◽  
Yukio Ozaki ◽  
Mamoru Nanasato ◽  
Masato Ishikawa ◽  
Ryo Nagasaka ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Frequency Domain ◽  
Intravascular Ultrasound ◽  
Small Sample ◽  
Optical Frequency ◽  
Lumen Area ◽  
Optical Frequency Domain Imaging ◽  
End Point ◽  
Percutaneous Coronary ◽  
Biolimus A9

Background: Given the characteristic differences between intravascular ultrasound (IVUS) and optical frequency domain imaging (OFDI), their approach to therapeutic guidance during percutaneous coronary interventions (PCIs) and arterial healing response after stenting may also vary. Methods: MISTIC-1 (The Multimodality Imaging Study in Cardiology cohort 1) is a multicenter, randomized-controlled, noninferiority trial that compared imaging end points between OFDI- and IVUS-guided PCI. Patients with stable coronary artery disease were randomly assigned to either OFDI- or IVUS-guided PCI using a Biolimus A9-eluting stent according to a prespecified protocol for imaging guidance. Stent sizing was based on external elastic lamina in IVUS-guided PCI while lumen up-size in OFDI-guided PCI. Postprocedural OFDI was investigated regardless of randomization, while operators in IVUS-guided PCI arm were blinded to the images. The primary end point was in-segment minimum lumen area assessed using OFDI at 8 months, while the secondary end point was a composite of cardiovascular mortality, target-vessel myocardial infarction, or target-lesion revascularization (device-oriented composite end point). Patients were followed up to 3 years after the index procedure. Results: A total of 109 patients (mean age 70 years, male 78%) with 126 lesions were enrolled. Postprocedural minimum stent area was 6.31±1.89 and 6.72±2.08 mm 2 in OFDI and IVUS group, respectively ( P =0.26). At the 8-month follow-up, in-segment minimum lumen area was 4.56±1.94 and 4.13±1.86 mm 2 in OFDI and IVUS group, respectively ( P non-inferiority <0.001). Both groups had comparable neointimal healing score (median 0.16 [interquartile range, 0.00–3.14] versus 0.90 [0.00–3.30], respectively; P =0.43). The incidence rate of device-oriented composite end point at 3 years was 7.4% and 7.3% in OFDI and IVUS group, respectively (hazard ratio, 1.05 [95% CI, 0.26–4.18]; P =0.95). Conclusions: OFDI-guided PCI was not inferior to IVUS-guided PCI in terms of in-segment minimum lumen area at 8 months. Although a small sample size was acknowledged, OFDI could be an alternative to IVUS when considering intracoronary imaging-guided PCI in selected populations with coronary artery diseases. Registration: URL: https://www.clinicaltrials.gov . Unique identifier: NCT03292081.

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