Author + information
- Received April 27, 2015
- Accepted May 3, 2015
- Published online September 1, 2015.
- Peiren Shan, MD∗,†,‡,
- Apurva Motivala, MD†,
- Jeffrey Moses, MD∗,†,
- Akiko Maehara, MD∗,†,
- Gary S. Mintz, MD∗ and
- Ziad A. Ali, MD, DPhil∗,†∗ ()
- ∗Cardiovascular Research Foundation, New York, New York
- †Columbia University Medical Center, Division of Cardiology, Center for Interventional Vascular Therapy, New York, New York
- ‡The First Affiliated Hospital of Wenzhou Medical University, Division of Cardiology, Zhejiang, China
- ↵∗Reprint requests and correspondence:
Dr. Ziad A. Ali, Center for Interventional Vascular Therapy, Division of Cardiology, New York Presbyterian Hospital and Columbia University, 161 Fort Washington Avenue, New York 10032, New York.
- bioresorbable vascular scaffold
- intravascular imaging
- intravascular ultrasound
- optical coherence tomography
- percutaneous coronary intervention
A 61-year-old woman with hypertension and dyslipidemia underwent coronary artery angiography for non–ST-segment elevation acute coronary syndrome. Angiography showed a focal severe stenosis in the middle portion of the right coronary artery (Figure 1, upper left panel). The lesion was pre-dilated with a 3.0 × 10-mm scoring balloon (AngioSculpt, AngioScore, Fremont, California) with subsequent implantation of a 3.5 × 18-mm Absorb everolimus-eluting bioresorbable vascular scaffold (BRS) (Abbott Vascular, Santa Clara, California) at 14 atm. Final post-dilation with a noncompliant balloon (NC Trek 4.0 × 12 mm, Abbott Vascular) was performed (Figure 1, bottom left panel). To compare imaging modalities for optimal BRS implantation, intravascular imaging assessment with both new-generation high-frequency (50 MHz, up to 70 MHz) combined near-infrared spectroscopy and intravascular ultrasound (NIRS-IVUS) (InfraRedX, Burlington, Massachusetts) and optical coherence tomography (OCT) (Ilumien, St. Jude Medical, Saint Paul, Minnesota) was performed. Both modalities showed complete apposition and adequate scaffold expansion with an inner minimum scaffold area of 9.3 mm2 by IVUS and 9.0 mm2 by OCT. High-frequency IVUS (Figure 1, A1–A3) showed leading and trailing, but not lateral edges of the BRS struts more clearly defined on OCT (Figure 1, B1–B3). However, plaque burden and external elastic lamina were more clearly defined on high-frequency IVUS.
OCT is regarded as having better measuring capacity to detect qualitative and quantitative findings, when compared with conventional IVUS, due to higher resolution for BRS (1,2). Here we show, for the first time, direct comparison between high-frequency IVUS and OCT. These findings suggest that high-frequency IVUS may provide an alternative modality to OCT for guiding BRS implantation.
Dr. Shan has received grant support from Boston Scientific Corporation. Dr. Moses is a consultant for Abbott and Boston Scientific Corporation. Dr. Maehara has received grant support from Boston Scientific Corporation; and is a consultant for Boston Scientific Corporation and ACIST. Dr. Mintz has received grant support from Boston Scientific Corporation, Volcano Corporation, St. Jude Medical, and InfraRedX; and is a consultant for Boston Scientific Corporation and Volcano Corporation. Dr. Ali has received grant support and is a consultant for St. Jude Medical and InfraRedX. Dr. Motivala has reported that he has no relationships relevant to the contents of this paper to disclose.
- Received April 27, 2015.
- Accepted May 3, 2015.
- American College of Cardiology Foundation
- Brown A.J.,
- McCormick L.M.,
- Hoole S.P.,
- West N.E.