Optical Coherence Tomography and Coronary Dissection: Precious Tool or Useless Surplus?

Overview

Journal Front Cardiovasc Med

Specialty Cardiology & Vascular Diseases

Date 2022 Apr 18

PMID 35433885

Authors

Lucia Barbieri

Andrea DErrico

Carlo Avallone

Domitilla Gentile

Giovanni Provenzale

Giulio Guagliumi

Gabriele Tumminello

Stefano Carugo

Affiliations

Soon will be listed here.

Abstract

Spontaneous coronary artery dissection (SCAD) is a rare clinical condition, but frequently manifested as acute myocardial infarction. In this particular setting, in recent years, optical coherence tomography (OCT) has been established as a possible diagnostic method due to the high spatial resolution (10-20 μm), which can visualize the different layers of coronary vessels. OCT can better analyze the "binary" or double lumen morphology, typical of this entity. Furthermore, it can identify the entrance breach and the circumferential and longitudinal extension of the lesion. However, we have to emphasize that this technique is not free from complications. OCT could further aggravate a dissection or exacerbate a new intimal tear. Therefore, the use of OCT in the evaluation of SCAD should be defined by balancing the diagnostic benefits versus procedural risks. Moreover, we underline that as SCAD is a rare condition and OCT is a recently introduced technique in clinical practice, limited data is available in literature.

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References

Brezinski M, Tearney G, Bouma B, Izatt J, Hee M, Swanson E . Optical coherence tomography for optical biopsy. Properties and demonstration of vascular pathology. Circulation. 1996; 93(6):1206-13. DOI: 10.1161/01.cir.93.6.1206. View

Tearney G, Regar E, Akasaka T, Adriaenssens T, Barlis P, Bezerra H . 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. J Am Coll Cardiol. 2012; 59(12):1058-72. DOI: 10.1016/j.jacc.2011.09.079. View

Yeung D, Saw J . Multiple recurrences of spontaneous coronary artery dissection in a woman with fibromuscular dysplasia. Catheter Cardiovasc Interv. 2019; 94(5):702-705. DOI: 10.1002/ccd.28301. View

Hebsgaard L, Nielsen T, Tu S, Krusell L, Maeng M, Veien K . Co-registration of optical coherence tomography and X-ray angiography in percutaneous coronary intervention. the Does Optical Coherence Tomography Optimize Revascularization (DOCTOR) fusion study. Int J Cardiol. 2015; 182:272-8. DOI: 10.1016/j.ijcard.2014.12.088. View

Thayer J, HEALY R, Maggs P . Spontaneous coronary artery dissection. Ann Thorac Surg. 1987; 44(1):97-102. DOI: 10.1016/s0003-4975(10)62372-7. View

Kaadan M, MacDonald C, Ponzini F, Duran J, Newell K, Pitler L . Prospective Cardiovascular Genetics Evaluation in Spontaneous Coronary Artery Dissection. Circ Genom Precis Med. 2018; 11(4):e001933. DOI: 10.1161/CIRCGENETICS.117.001933. View

Saw J, Mancini G, Humphries K . Contemporary Review on Spontaneous Coronary Artery Dissection. J Am Coll Cardiol. 2016; 68(3):297-312. DOI: 10.1016/j.jacc.2016.05.034. View

Su M, Chen C, Yeh H, Wang K . Concise Review of Optical Coherence Tomography in Clinical Practice. Acta Cardiol Sin. 2016; 32(4):381-6. PMC: 4963413. DOI: 10.6515/acs20151026a. View

Jang I, Bouma B, Park S, Park S, Seung K, Choi K . Visualization of coronary atherosclerotic plaques in patients using optical coherence tomography: comparison with intravascular ultrasound. J Am Coll Cardiol. 2002; 39(4):604-9. DOI: 10.1016/s0735-1097(01)01799-5. View

10.

Alfonso F, Paulo M, Gonzalo N, Dutary J, Jimenez-Quevedo P, Lennie V . Diagnosis of spontaneous coronary artery dissection by optical coherence tomography. J Am Coll Cardiol. 2012; 59(12):1073-9. DOI: 10.1016/j.jacc.2011.08.082. View

11.

Tearney G, Waxman S, Shishkov M, Vakoc B, Suter M, Freilich M . Three-dimensional coronary artery microscopy by intracoronary optical frequency domain imaging. JACC Cardiovasc Imaging. 2009; 1(6):752-61. PMC: 2852244. DOI: 10.1016/j.jcmg.2008.06.007. View

12.

Ghadri J, Wittstein I, Prasad A, Sharkey S, Dote K, Akashi Y . International Expert Consensus Document on Takotsubo Syndrome (Part I): Clinical Characteristics, Diagnostic Criteria, and Pathophysiology. Eur Heart J. 2018; 39(22):2032-2046. PMC: 5991216. DOI: 10.1093/eurheartj/ehy076. View

13.

Jackson R, Al-Hussaini A, Joseph S, van Soest G, Wood A, Macaya F . Spontaneous Coronary Artery Dissection: Pathophysiological Insights From Optical Coherence Tomography. JACC Cardiovasc Imaging. 2019; 12(12):2475-2488. DOI: 10.1016/j.jcmg.2019.01.015. View

14.

Varga Z, Narayana Gowda S, Sethi P, Stys A . Optical Coherence Tomography in Intracoronary Diagnostics. S D Med. 2020; 73(5):202-207. View

15.

Franklin B, Thompson P, Al-Zaiti S, Albert C, Hivert M, Levine B . Exercise-Related Acute Cardiovascular Events and Potential Deleterious Adaptations Following Long-Term Exercise Training: Placing the Risks Into Perspective-An Update: A Scientific Statement From the American Heart Association. Circulation. 2020; 141(13):e705-e736. DOI: 10.1161/CIR.0000000000000749. View

16.

Turley T, OByrne M, Kosel M, de Andrade M, Gulati R, Hayes S . Identification of Susceptibility Loci for Spontaneous Coronary Artery Dissection. JAMA Cardiol. 2020; 5(8):929-938. PMC: 7203673. DOI: 10.1001/jamacardio.2020.0872. View

17.

Eleid M, Guddeti R, Tweet M, Lerman A, Singh M, Best P . Coronary artery tortuosity in spontaneous coronary artery dissection: angiographic characteristics and clinical implications. Circ Cardiovasc Interv. 2014; 7(5):656-62. DOI: 10.1161/CIRCINTERVENTIONS.114.001676. View

18.

Krittanawong C, Gulati R, Eitzman D, Jneid H . Revascularization in Patients With Spontaneous Coronary Artery Dissection: Where Are We Now?. J Am Heart Assoc. 2021; 10(13):e018551. PMC: 8403332. DOI: 10.1161/JAHA.120.018551. View

19.

Saw J, Ricci D, Starovoytov A, Fox R, Buller C . Spontaneous coronary artery dissection: prevalence of predisposing conditions including fibromuscular dysplasia in a tertiary center cohort. JACC Cardiovasc Interv. 2012; 6(1):44-52. DOI: 10.1016/j.jcin.2012.08.017. View

20.

Takarada S, Imanishi T, Liu Y, Ikejima H, Tsujioka H, Kuroi A . Advantage of next-generation frequency-domain optical coherence tomography compared with conventional time-domain system in the assessment of coronary lesion. Catheter Cardiovasc Interv. 2009; 75(2):202-6. DOI: 10.1002/ccd.22273. View