Associations of coronary plaque characteristics by integrated backscatter intravascular ultrasound with detectability of vessel external elastic lamina using optical frequency domain imaging in human coronary arteries: A sub-analysis of the MISTIC-1 trial

Masato Ishikawa, Takashi Muramatsu, Mamoru Nanasato, Ryo Nagasaka, Hidemaro Takatsu, Yu Yoshiki, Yosuke Hashimoto, Masaya Ohota, Masanori Okumura, Hiroyuki Naruse, Junichi Ishii, Katsuyoshi Ito, Hiroshi Takahashi, Hiroki Kamiya, Yukihiko Yoshida, Yukio Ozaki

Research output: Contribution to journalArticle

Abstract

Objectives: We sought to examine associations between plaque characteristics by intravascular ultrasound (IVUS) and detectability of external elastic lamina (EEL) by optical frequency domain imaging (OFDI) in human coronary arteries. Background: It is often challenging to detect EEL which represents vessel size by light-based imaging modalities due to light intensity attenuation through atherosclerotic plaque. Methods: IVUS and OFDI prior to stent implantation were sequentially investigated per protocol. We identified corresponding cross-sections by minimum lumen area (MLA) or just distally to side branches as anatomical landmarks. Plaque characterization was determined by integrated backscatter IVUS analysis. We categorized detectable EEL arc by OFDI into four groups: 0≤ and <1 quadrant (group 1), 1≤ and <2 quadrants (group 2), 2≤ and <3 quadrants (group 3), or 3≤ and <4 quadrants (group 4). Results: We prospectively studied 103 vessels in 93 patients with stable coronary artery disease. Corresponding 711 cross-sections were analyzed. Cross-sections with detectable EEL arc <2 quadrants (group 1 or 2) were observed in 86.1% of MLA sites but only in 29.3% of non-MLA sites (p <.05). Percentage plaque area (%PA) appeared to be the strongest predictor to detect EEL arc <2 quadrants with the cut-off of 60.3% (AUC 0.90; sensitivity 79.8%, specificity 85.5%). Lipid pool and calcification remained statistically significant in predicting detectable EEL arc <2 quadrants after adjustment with %PA. Conclusions: Presence of large plaque burden, lipid pool, and calcification significantly predicts the detectability of EEL by OFDI assessment. Locations with detectable EEL arc <2 quadrants should thus be avoided for optimal stent landing zone.

Original languageEnglish
JournalCatheterization and Cardiovascular Interventions
DOIs
Publication statusPublished - 01-01-2019

Fingerprint

Stents
Coronary Vessels
Lipids
Light
Atherosclerotic Plaques
Area Under Curve
Coronary Artery Disease
Sensitivity and Specificity

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Ishikawa, Masato ; Muramatsu, Takashi ; Nanasato, Mamoru ; Nagasaka, Ryo ; Takatsu, Hidemaro ; Yoshiki, Yu ; Hashimoto, Yosuke ; Ohota, Masaya ; Okumura, Masanori ; Naruse, Hiroyuki ; Ishii, Junichi ; Ito, Katsuyoshi ; Takahashi, Hiroshi ; Kamiya, Hiroki ; Yoshida, Yukihiko ; Ozaki, Yukio. / Associations of coronary plaque characteristics by integrated backscatter intravascular ultrasound with detectability of vessel external elastic lamina using optical frequency domain imaging in human coronary arteries : A sub-analysis of the MISTIC-1 trial. In: Catheterization and Cardiovascular Interventions. 2019.
@article{dc8982522e9e4d8fa0678d66a8ab037d,
title = "Associations of coronary plaque characteristics by integrated backscatter intravascular ultrasound with detectability of vessel external elastic lamina using optical frequency domain imaging in human coronary arteries: A sub-analysis of the MISTIC-1 trial",
abstract = "Objectives: We sought to examine associations between plaque characteristics by intravascular ultrasound (IVUS) and detectability of external elastic lamina (EEL) by optical frequency domain imaging (OFDI) in human coronary arteries. Background: It is often challenging to detect EEL which represents vessel size by light-based imaging modalities due to light intensity attenuation through atherosclerotic plaque. Methods: IVUS and OFDI prior to stent implantation were sequentially investigated per protocol. We identified corresponding cross-sections by minimum lumen area (MLA) or just distally to side branches as anatomical landmarks. Plaque characterization was determined by integrated backscatter IVUS analysis. We categorized detectable EEL arc by OFDI into four groups: 0≤ and <1 quadrant (group 1), 1≤ and <2 quadrants (group 2), 2≤ and <3 quadrants (group 3), or 3≤ and <4 quadrants (group 4). Results: We prospectively studied 103 vessels in 93 patients with stable coronary artery disease. Corresponding 711 cross-sections were analyzed. Cross-sections with detectable EEL arc <2 quadrants (group 1 or 2) were observed in 86.1{\%} of MLA sites but only in 29.3{\%} of non-MLA sites (p <.05). Percentage plaque area ({\%}PA) appeared to be the strongest predictor to detect EEL arc <2 quadrants with the cut-off of 60.3{\%} (AUC 0.90; sensitivity 79.8{\%}, specificity 85.5{\%}). Lipid pool and calcification remained statistically significant in predicting detectable EEL arc <2 quadrants after adjustment with {\%}PA. Conclusions: Presence of large plaque burden, lipid pool, and calcification significantly predicts the detectability of EEL by OFDI assessment. Locations with detectable EEL arc <2 quadrants should thus be avoided for optimal stent landing zone.",
author = "Masato Ishikawa and Takashi Muramatsu and Mamoru Nanasato and Ryo Nagasaka and Hidemaro Takatsu and Yu Yoshiki and Yosuke Hashimoto and Masaya Ohota and Masanori Okumura and Hiroyuki Naruse and Junichi Ishii and Katsuyoshi Ito and Hiroshi Takahashi and Hiroki Kamiya and Yukihiko Yoshida and Yukio Ozaki",
year = "2019",
month = "1",
day = "1",
doi = "10.1002/ccd.28218",
language = "English",
journal = "Catheterization and Cardiovascular Interventions",
issn = "1522-1946",
publisher = "Wiley-Liss Inc.",

}

Associations of coronary plaque characteristics by integrated backscatter intravascular ultrasound with detectability of vessel external elastic lamina using optical frequency domain imaging in human coronary arteries : A sub-analysis of the MISTIC-1 trial. / Ishikawa, Masato; Muramatsu, Takashi; Nanasato, Mamoru; Nagasaka, Ryo; Takatsu, Hidemaro; Yoshiki, Yu; Hashimoto, Yosuke; Ohota, Masaya; Okumura, Masanori; Naruse, Hiroyuki; Ishii, Junichi; Ito, Katsuyoshi; Takahashi, Hiroshi; Kamiya, Hiroki; Yoshida, Yukihiko; Ozaki, Yukio.

In: Catheterization and Cardiovascular Interventions, 01.01.2019.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Associations of coronary plaque characteristics by integrated backscatter intravascular ultrasound with detectability of vessel external elastic lamina using optical frequency domain imaging in human coronary arteries

T2 - A sub-analysis of the MISTIC-1 trial

AU - Ishikawa, Masato

AU - Muramatsu, Takashi

AU - Nanasato, Mamoru

AU - Nagasaka, Ryo

AU - Takatsu, Hidemaro

AU - Yoshiki, Yu

AU - Hashimoto, Yosuke

AU - Ohota, Masaya

AU - Okumura, Masanori

AU - Naruse, Hiroyuki

AU - Ishii, Junichi

AU - Ito, Katsuyoshi

AU - Takahashi, Hiroshi

AU - Kamiya, Hiroki

AU - Yoshida, Yukihiko

AU - Ozaki, Yukio

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Objectives: We sought to examine associations between plaque characteristics by intravascular ultrasound (IVUS) and detectability of external elastic lamina (EEL) by optical frequency domain imaging (OFDI) in human coronary arteries. Background: It is often challenging to detect EEL which represents vessel size by light-based imaging modalities due to light intensity attenuation through atherosclerotic plaque. Methods: IVUS and OFDI prior to stent implantation were sequentially investigated per protocol. We identified corresponding cross-sections by minimum lumen area (MLA) or just distally to side branches as anatomical landmarks. Plaque characterization was determined by integrated backscatter IVUS analysis. We categorized detectable EEL arc by OFDI into four groups: 0≤ and <1 quadrant (group 1), 1≤ and <2 quadrants (group 2), 2≤ and <3 quadrants (group 3), or 3≤ and <4 quadrants (group 4). Results: We prospectively studied 103 vessels in 93 patients with stable coronary artery disease. Corresponding 711 cross-sections were analyzed. Cross-sections with detectable EEL arc <2 quadrants (group 1 or 2) were observed in 86.1% of MLA sites but only in 29.3% of non-MLA sites (p <.05). Percentage plaque area (%PA) appeared to be the strongest predictor to detect EEL arc <2 quadrants with the cut-off of 60.3% (AUC 0.90; sensitivity 79.8%, specificity 85.5%). Lipid pool and calcification remained statistically significant in predicting detectable EEL arc <2 quadrants after adjustment with %PA. Conclusions: Presence of large plaque burden, lipid pool, and calcification significantly predicts the detectability of EEL by OFDI assessment. Locations with detectable EEL arc <2 quadrants should thus be avoided for optimal stent landing zone.

AB - Objectives: We sought to examine associations between plaque characteristics by intravascular ultrasound (IVUS) and detectability of external elastic lamina (EEL) by optical frequency domain imaging (OFDI) in human coronary arteries. Background: It is often challenging to detect EEL which represents vessel size by light-based imaging modalities due to light intensity attenuation through atherosclerotic plaque. Methods: IVUS and OFDI prior to stent implantation were sequentially investigated per protocol. We identified corresponding cross-sections by minimum lumen area (MLA) or just distally to side branches as anatomical landmarks. Plaque characterization was determined by integrated backscatter IVUS analysis. We categorized detectable EEL arc by OFDI into four groups: 0≤ and <1 quadrant (group 1), 1≤ and <2 quadrants (group 2), 2≤ and <3 quadrants (group 3), or 3≤ and <4 quadrants (group 4). Results: We prospectively studied 103 vessels in 93 patients with stable coronary artery disease. Corresponding 711 cross-sections were analyzed. Cross-sections with detectable EEL arc <2 quadrants (group 1 or 2) were observed in 86.1% of MLA sites but only in 29.3% of non-MLA sites (p <.05). Percentage plaque area (%PA) appeared to be the strongest predictor to detect EEL arc <2 quadrants with the cut-off of 60.3% (AUC 0.90; sensitivity 79.8%, specificity 85.5%). Lipid pool and calcification remained statistically significant in predicting detectable EEL arc <2 quadrants after adjustment with %PA. Conclusions: Presence of large plaque burden, lipid pool, and calcification significantly predicts the detectability of EEL by OFDI assessment. Locations with detectable EEL arc <2 quadrants should thus be avoided for optimal stent landing zone.

UR - http://www.scopus.com/inward/record.url?scp=85065143105&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85065143105&partnerID=8YFLogxK

U2 - 10.1002/ccd.28218

DO - 10.1002/ccd.28218

M3 - Article

AN - SCOPUS:85065143105

JO - Catheterization and Cardiovascular Interventions

JF - Catheterization and Cardiovascular Interventions

SN - 1522-1946

ER -