张林娜,侯静波

• 1:哈尔滨医科大学附属第二医院心内科
• 2:心肌缺血省部共建教育部重点实验室

摘要(Abstract)：

<正>光学相干断层成像系统(optical coherence tomography,OCT)是一种高分辨率的医学断层成像技术,可以提供冠状动脉的微观成像。OCT定义的薄纤维帽斑块是指纤维帽厚度不足65μm的脂质斑块,常用作评估经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)术后并发症,如无复流、微血管阻塞及术后肌钙蛋白升高等事件的发生;用于观察支架贴壁不良、组织脱垂及支架边缘撕裂;观察支架小梁新生内膜覆盖,同时还可以观察某些支架的晚期不良结局,如支架内血栓和再狭窄。可以说OCT在评价冠状动脉粥样斑块和指导PCI术的优势开启了心脏介入学的新视野[1-2]。本文主要综述OCT在PCI术后评估中的应用。

关键词(KeyWords)： 光学相干断层成像系统;介入治疗

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 张林娜,侯静波

参考文献(References)：

• [1]Tearney GJ,Regar E,Akasaka T,et al.Consensus standards for acquisition,measurement,and reporting of intravascular optical coherence tomography studies:a report from the international working group for intravascular optical coherence tomography standardization and validation.JACC Cardiovasc Interv,2012,59:1058-1072.
• [2]Kubo T,Ino Y,Akasaka T,et al.Optical coherence tomography imaging in acute coronary syndromes.Cardiol Res Pract,2011,Article ID 312978.
• [3]Tsuchida K,Van der Giessen WJ,Patterson M,et al.In vivo validation of a novel three-dimensional quantitative coronary angiography system(CardiOp-B):Comparison with a conventional two-dimensional system(CAAS II)and with special reference to optical coherence tomography.EuroIntervention,2007,3:100-108.
• [4]Takarada S,Imanishi T,Liu Y,et al.Advantage of next-generation frequency-domain optical coherence tomography compared with conventional time-domain system in the assessment of coronary lesion.Catheter Cardiovasc Interv,2010,75:202-206.
• [5]Ozaki Y,Kitabata H,Tsujioka H,et al.Comparison of contrast media and low-molecular-weight dextran for frequency-domain optical coherence tomography.Circ J,2012,76:922-927.
• [6]Bezerra HG,Costa MA,Guagliumi G,et al.Intracoronary optical coherence tomography:A comprehensive review clinical and research applications.JACC Cardiovasc Interv,2009,2:1035-1046.
• [7]Kubo T,Imanishi T,Kitabata H,et al.Comparison of vascular response after sirolimus-eluting stent implantation between patients with unstable and stable angina pectoris:A serial optical coherence tomography study.JACC Cardiovasc Imaging,2008,1:475-484.
• [8]Finn AV,Nakazawa G,Joner M,et al.Vascular responses to drug eluting stents:Importance of delayed healing.Arterioscler Thromb Vasc Biol,2007,27:1500-1510.
• [9]Kume T,Okura H,Miyamoto Y,et al.Natural history of stent edge dissection,tissue protrusion and incomplete stent apposition detectable only on optical coherence tomography after stent implantation:Preliminary observation.Circ J,2012,76:698-703.
• [10]Gonzalo N,Serruys PW,Okamura T,et al.Relation between plaque type and dissections at the edges after stent implantation:An optical coherence tomography study.Int J Cardiol,2011,150:151-155.
• [11]Matsumoto D,Shite J,Shinke T,et al.Neointimal coverage of sirolimus-eluting stents at 6-month follow-up:Evaluated by optical coherence tomography.Eur Heart J,2007,28:961-967.
• [12]Chen BX,Ma FY,Luo W,et al.Neointimal coverage of baremetal and sirolimus-eluting stents evaluated with optical coherence tomography.Heart,2008,94:566-570.
• [13]Takano M,Murakami D,Yamamoto M,et al.Six-month followup evaluation for everolimus-eluting stents by intracoronary optical coherence tomography:Comparison with paclitaxel-eluting stents.Int J Cardiol,2011,166:181-186.
• [14]Tahara S,Bezerra HG,Sirbu V,et al.Angiographic,IVUS and OCT evaluation of the long-term impact of coronary disease severity at the site of overlapping drug-eluting and bare metal stents:A substudy of the ODESSA trial.Heart,2010,96:1574-1578.
• [15]Kubo T,Matsuo Y,Okumoto Y,et al.Diagnostic accuracy of 64-slice multislice computed tomography to assess coronary stent thrombosis as determined by intravascular optical coherence tomography.JACC Cardiovasc Imaging,2011,4:1040-1043.
• [16]Liu Y,Imanishi T,Kubo T,et al.Assessment by optical coherence tomography of stent struts across side branch:Comparison of baremetal stents and drug-elution stents.Circ J,2011,75:106-112.
• [17]Guagliumi G,Capodanno D,Ikejima H,et al.Impact of different stent alloys on human vascular response to everolimus-eluting stent:An optical coherence tomography study:The OCTEVEREST.Catheter Cardiovasc Interv,2012,81:510-518.
• [18]Kitabata H,Kubo T,Komukai K,et al.Effect of strut thickness on neointimal atherosclerotic change over an extended follow-up period(≥4 years)after bare-metal stent implantation:Intracoronary optical coherence tomography examination.Am Heart J,2012,163:608-616.
• [19]Guagliumi G,Ikejima H,Sirbu V,et al.Impact of drug release kinetics on vascular response to different zotarolimus-eluting stents implanted in patients with long coronary stenoses:The Long OCT study(Optical Coherence Tomography in Long Lesions).JACC Cardiovasc Interv,2011,4:778-785.
• [20]Finn AV,Joner M,Nakazawa G,et al.Pathological correlates of late drug-eluting stent thrombosis:Strut coverage as a marker of endothelialization.Circulation,2007,115:2435-2441.
• [21]Cook S,Wenaweser P,Togni M,et al.Incomplete stent apposition and very late stent thrombosis after drug-eluting stent implantation.Circulation,2007,115:2426-2434.
• [22]Imai M,Kadota K,Goto T,et al.Incidence,risk factors,and clinical sequelae of angiographic peri-stent contrast staining after sirolimuseluting stent implantation.Circulation,2011,123:2382-2391.
• [23]Guagliumi G,Sirbu V,Musumeci G,et al.Examination of the in vivo mechanisms of late drug-eluting stent thrombosis:Findings from optical coherence tomography and intravascular ultrasound imaging.JACC Cardiovasc Interv,2012,5:12-20.
• [24]Ino Y,Kubo T,Kitabata H,et al.Impact of hinge motion on in-stent restenosis after sirolimus-eluting stent implantation.Circ J,2011,75:1878-1884.
• [25]Akasaka T.What can we expect in PCI in patients with chronic coronary artery disease.Indication of PCI for angiographically signifi cant coronary artery stenosis without objective evidence of myocardial ischemia(Con).Circ J,2011,75:211-217.
• [26]Gonzalo N,Serruys PW,Okamura T,et al.Optical coherence tomography patterns of stent restenosis.Am Heart J,2009,158:284-293.
• [27]Kume T,Akasaka T,Kawamoto T,et al.Visualization of neointima formation by optical coherence tomography.Int Heart J,2005,46:1133-1136.
• [28]Nagai H,Ishibashi-Ueda H,Fujii K.Histology of highly echolucent regions in optical coherence tomography images from two patients with sirolimus-eluting stent restenosis.Catheter Cardiovasc Interv,2010,75:961-963.
• [29]Takano M,Yamamoto M,Inami S,et al.Appearance of lipid-laden intima and neovascularization after implantation of bare-metal stents extended late-phase observation by intracoronary optical coherence tomography.J Am Coll Cardiol,2009,55:26-32.
• [30]Kang SJ,Mintz GS,Akasaka T,et al.Optical coherence tomographic analysis of in-stent neoatherosclerosis after drug-eluting stent implantation.Circulation,2011,123:2954-2963.
• [31]Fineschi MGT,Pierli C,Casini S,et al.Outcome of percutaneous hybrid coronary revascularization:bare metal stents jeopardize the benefi t of sirolimus-eluting stents in the real world.Can J Cardiol,2005,21:1281-1285.
• [32]Chen MS,John JM,Chew DP,et al.Bare metal stent restenosis is not a benign clinical entity.Am Heart J,2006,151:1260-1264.
• [33]Yonetsu T,Kim JS,Kato K,et al.Comparison of incidence and time course of neoatherosclerosis between bare metal stents and drugeluting stents using optical coherence tomography.Am J Cardiol,2012,110:933-939.
• [34]Hou J,Qi H,Zhang M,et al.Development of lipid-rich plaque inside bare metal stent:possible mechanism of late stent thrombosis?An optical coherence tomography study.Heart,2010,96:1187-1190.
• [35]Lee CW,Kang SJ,Park DW,et al.Intravascular ultrasound fi ndings in patients with very late stent thrombosis after either drug-eluting or bare-metal stent implantation.J Am Coll Cardiol,2010,55:1936-1942.
• [36]Farooq V,Gogas BD,Okamura T,et al.Three-dimensional optical frequency domain imaging in conventional percutaneous coronary intervention:The potential for clinical application.Eur Heart J,2011,34:875-885.