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Archives of cardiovascular diseases
Volume 103, n° 4
pages 215-226 (avril 2010)
Doi : 10.1016/j.acvd.2010.03.002
Received : 10 February 2010 ;  accepted : 4 Mars 2010
High-resolution coronary imaging by optical coherence tomography: Feasibility, pitfalls and artefact analysis
Tomographie par cohérence optique : faisabilité, limites et analyses des artéfacts d’une imagerie coronaire de haute résolution

Figure 1

Figure 1 : 

Examples of optical coherence tomography images. A. Healthy coronary. B. Thin cap fibro-atheroma plaque. C. Six-month follow-up of a few stents: different levels of neointimal hyperplasia thickness and strut coverage. A few struts remain uncovered (top left). Stent restenosis (bottom right).

Figure 2

Figure 2 : 

Optical coherence tomography images of rotation artefacts on stented (A) and healthy coronary (B). Absence of artefact on immobile acquisitions on phantom (C) or explanted heart coronary (E). Test-bench reproductions of rotation artefacts (60 oscillations/min; amplitude, 1cm) for both models (D and F).

Figure 3

Figure 3 : 

Examples of artefacts on optical coherence tomography cross-sections. A. Decentrated fibre at a large angle. Only the semi-circumference nearer the fibre is analysable. B. Same artery as (A), 4.47mm diameter with centred fibre. C. Signal intense near decentrated fibre and defective illumination of remote structures. D. Petal-shaped deformation on decentrated fibre. E. Flush defect. F. Same coronary as (E) with effective flush.

Figure 4

Figure 4 : 

Example of stent analysis hindered by occlusion balloon. Perfect image in (A), unaffected by balloon tip (B). Uninterpretable images due to radio-opaque balloon markers stopping signal (C) or upstream of balloon (D).

Figure 5

Figure 5 : 

Intravascular ultrasound (top) and optical coherence tomography (OCT) (bottom) cross-sections at same level in pathological right coronary artery (mixed fibrocalcified plaque). Example of advantages and limitations of OCT, with penetration defect preventing full analysis of wall thickness, but higher superficial resolution, enabling measurement of fibrous cap thickness.

Figure 6

Figure 6 : 

Ambiguities in analysis of strut coverage in two drug-eluting stents checked at 6 months post-implantation. Some struts appear covered (white arrows), but endothelial coverage may in some cases be too thin for optical coherence tomography’s resolution (10μm) (yellow arrows) (A). Coverage aspect suggests thrombus (red arrows) (B).

Figure 7

Figure 7 : 

Illustration of false image of malapposition. A clear space corresponds to strut thickness (yellow rectangles), between wall and luminous signal from the first interface between strut and transparent medium.

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