Optical coherence tomography (OCT) evaluation of intermediate coronary lesions in patients with NSTEMI

Cardiovascular Revascularization Medicine : Including Molecular Interventions
Nigussie BogaleAnthony Fung

Abstract

Coronary angiography is commonly performed following non-ST segment elevation myocardial infarction (NSTEMI) to assess the need for revascularization. Some of these patients have myocardial infarction (MI) with no obstructive coronary atherosclerosis (MINOCA). Patients without severe obstructive lesions are usually treated conservatively. However, coronary angiography has known limitations in the assessment of lesion severity. We report our experience of using coronary Optical Coherence Tomography (OCT) in a series of patients without severe obstructive coronary lesions. 165 patients underwent coronary OCT at Vancouver General Hospital. NSTEMI was the clinical presentation in 70 patients and 26 had angiographically intermediate lesions with 40%-69% diameter stenosis. Prior to OCT image acquisition, intracoronary nitroglycerin 100-200μg was administered. Blood in the vessel was displaced using contrast media by manual injections. OCT of the angiographically intermediate lesions showed larger minimal luminal area (MLA) than the angiographically severe lesions (MLA 3.3mm(2)±1.8mm(2) vs. 1.6mm(2)±0.6mm(2), p<0.001) and less severe % lumen area stenosis (54.2%±11.4% vs. 70.9%±6.8%, p=0.001). Plaque rupture or intracoronary thrombus ...Continue Reading

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Citations

Mar 21, 2016·Cardiovascular Revascularization Medicine : Including Molecular Interventions·Luis Ortega-PazHector M Garcia-Garcia
Sep 10, 2016·Journal of the American College of Cardiology·Abdul HakeemBarry F Uretsky
Nov 5, 2016·Nature Reviews. Cardiology·Gerard PasterkampPeter Libby
Sep 7, 2016·Scandinavian Cardiovascular Journal : SCJ·Kevin Kris Warnakula OlesenMichael Maeng
Aug 12, 2017·Current Opinion in Cardiology·Abdul HakeemBarry F Uretsky
May 8, 2020·Kardiologiia·Andrey V SherashovM Yu Gilyarov
Oct 30, 2018·Journal of the American Heart Association·Romana HerscoviciC Noel Bairey Merz
Jul 23, 2016·Current Cardiology Reports·Joanna M Joly, Vera Bittner
Aug 11, 2020·Journal of Interventional Cardiology·Caterina Mas-LladóVicente Peral-Disdier

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