自发再通冠状动脉血栓的光学相干断层成像特征-单中心经验。

IF 1.2 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Ankit Gupta, Raghavendra Rao K, Sreenivas Reddy S, Jeet Ram Kashyap, Vikas Kadiyala, Jaspreet Kaur, Debabrata Dash, Suraj Kumar, Munish Dev
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引用次数: 0

摘要

再通血栓是一种诊断不足的临床实体。目的是探讨光学相干断层扫描(OCT)在识别自发再通血栓(SRCT)的临床应用。方法:这是一项回顾性研究,分析了4年来2678张冠状动脉造影照片,其中75.8%的经皮冠状动脉介入治疗(PCI)包括血管内成像指导。34例SRCT血管造影怀疑表现模糊。结果:8例患者(男7例,女1例)行ct检查,2例行血管内超声(IVUS)检查。中位年龄为52岁(33-67岁)。根据临床症状诊断STEMI-2、NSTEMI-1、不稳定型心绞痛-3、慢性稳定型心绞痛-2。3例血管造影表现为隐蔽性/朦胧性;编织在2;2例假性解剖;近闭塞1例。OCT表现为多个小腔,高后向散射,信号丰富,隔层薄,内边界光滑,分隔管腔和内部通讯。多个孔洞的存在赋予了典型的“瑞士奶酪”或“莲藕”样外观,这是血栓再通的特征。SRCT病变长度为(四分位数中位数范围[IQR], 16.5[12.07-21.5] mm),最小管腔面积(中位数[IQR], 1.77 [0.93-3.26] mm2),明显狭窄(中位数[IQR], 74.0[67.0-81.0] %)。最小/最大通道数分别为(median [IQR], 2.0[2.0-2.0])和(median [IQR], 4.50[4.0-6.75])。以富脂斑块为主。IVUS显示有小腔的回声通道。除1例患者外,其余患者均行PCI。结论:OCT血管内显像能描绘血栓再通的特征,并能区分模棱两可的病变。大多数涉及SRCT的病变在症状和狭窄严重程度上都很明显,OCT需要PCI。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Optical coherence tomography characterization of spontaneous recanalized coronary thrombus - Single center experience.

Optical coherence tomography characterization of spontaneous recanalized coronary thrombus - Single center experience.

Optical coherence tomography characterization of spontaneous recanalized coronary thrombus - Single center experience.

Optical coherence tomography characterization of spontaneous recanalized coronary thrombus - Single center experience.

Introduction: Recanalized thrombus is an under diagnosed clinical entity. Aim was to investigate the utility of optical coherence tomography (OCT) in identifying spontaneously recanalized thrombi (SRCT) for management in clinical practice. Methods: This was a retrospective study analyzing 2678 coronary angiograms over a 4-year period which included intravascular imaging guidance in 75.8% of the percutaneous coronary interventions (PCI). Angiographic suspicion of SRCT has hazy appearance seen in 34 patients. Results: Eight patients (7 males and 1 female) were confirmed with SRCT on OCT and two underwent intravascular ultrasound (IVUS). Median age was 52 years (range 33-67 years). Based on clinical symptoms, diagnosis was STEMI-2, NSTEMI-1, unstable angina-3 and chronic stable angina-2. Angiographic patterns were veiled/hazy appearances in 3; braided in 2; pseudo dissection in 2; and near occlusion in 1 patient. OCT findings displayed multiple small cavities, signal-rich with high backscattering and thin septa with smooth inner borders dividing the lumen and intercommunications. Presence of multiple holes conferred typical "Swiss cheese" or 'lotus root' like appearance, characteristic of recanalized thrombi. SRCT lesion length was (median interquartile ranges [IQR], 16.5[12.07-21.5] mm) and minimal luminal area (median [IQR], 1.77 [0.93-3.26] mm2) with significant stenosis (median [IQR], 74.0[67.0-81.0] %). Minimum/maximum number of channels were (median [IQR], 2.0[2.0-2.0]) and (median [IQR], 4.50[4.0-6.75]) respectively. Lipid rich plaque was predominant. IVUS demonstrated echo-lucent channels with small cavities. All but one patient underwent PCI. Conclusion: Intravascular imaging by OCT delineates the characteristics of recanalized thrombi and distinguishes ambiguous lesions. Majority of the lesions involving SRCT were significant both symptomatic and stenosis severity wise on OCT requiring PCI.

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来源期刊
Journal of Cardiovascular and Thoracic Research
Journal of Cardiovascular and Thoracic Research CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
2.00
自引率
0.00%
发文量
22
审稿时长
7 weeks
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