Author + information
- Michael Joner1,
- Caroline Malle1,
- Tomohisa Tada1,
- Kristin Steigerwald1,
- Renu Virmani2 and
- Adnan Kastrati1
To validate optical coherence tomography (OCT) data for assessment of vascular healing in a preclinical animal model and to translate these findings to the assessment of vascular healing after drug eluting stent (DES) implantation in human autopsy cases and clinical practice.
The validation of OCT signal intensity analysis for tissue characterization remains to a scientific gap.
DES were imaged 28 and 42 days after implantation in atherosclerotic rabbits using OCT and evaluated by histology. Next OCT frames were matched with the corresponding histological cross sections, morphometric parameters were correlated and grey-scale signal intensity (GSI) was measured for identified mature or immature neointimal tissue. Human autopsy specimens were then imaged by OCT and GSI correlated with histology. Finally prospective OCT imaging and GSI measurements were acquired in 10 patients undergoing surveillance 6 months after implantation of DES.
Vascular healing in man at 6 months most closely compared with that of atherosclerotic rabbits at 28 days. GSI analysis showed that immature as compared to mature neointimal tissue showed lower values (48.5±17.9 versus 101.6±16.6). ROC curve analysis revealed high sensitivity and specificity for detecting mature neointima (98% and 85%, respectively) at a cut-off value of 70.7. In human autopsy specimens a total of 43 out of 57 (75,4%) tissue areas were judged to be mature by GSI analysis. Sensitivity and specificity were 93 %. Prospective OCT imaging in patients revealed 28.3% uncovered struts at 6 months. GSI analysis of covered struts revealed that 34.8% of tissue areas above stent struts represented mature neointima.
Vascular healing in man at 6 months most closely compared with that of atherosclerotic rabbits at 28 days and was reliably characterised by OCT imaging. Novel OCT grey-scale signal intensity analysis allows distinction between mature and immature neointimal tissue in animal models, autopsy specimens and patients undergoing invasive surveillance.
- 2013 American College of Cardiology Foundation