检测技术辅助判断 缺血相关血管课件.ppt

支架植入后即刻OCT比IVUS 应用OCT可以分辨冠状动脉支架植入术后支架周围超微结构特征 贴壁良好 贴壁不良 组织脱垂 内膜撕裂 韩志刚, 于波,中华心血管病杂志. 2006(07):625-626 * OCT与IVUS的比较 贴壁良好 * OCT与IVUS的比较 贴壁不良 * OCT与IVUS的比较 支架内白血栓 * 对支架后即刻效果的评价OCT优于IVUS 贴壁不良 组织脱垂 内膜撕裂 支架边缘夹层 支架内血栓 支架膨胀不全 * 支架内膜覆盖 * OCT与IVUS的比较 支架再狭窄 * OCT与IVUS的比较 支架内皮覆盖及微通道 * A B C Barlis et al. EuroInterv J 2008 内膜异质性 * 3D-OCT重建 * OCT与IVUS的比较 支架内斑块 * BMS内脂质斑块 * * In the IVUS Core Laboratory, for each coronary cross-section, technicians measured the external elastic membrane and the lumen areas, then calculated the atheroma area, shown here in gold. infiltrate * NV was found in 32 (34.8%) culprit lesions and 70 (34.5%) non-culprit lesions in UAP, and in 17 (27.9%) lesions in SAP (P=0.599). In UAP patients, the culprit lesions with NV, compared to the lesions without NV, had a higher prevalence of thin cap fibroatheroma (81.3% vs. 46.7%, P=0.001), thinner fibrous cap thickness (56.2±20.0 vs. 75.1±30.4 μm, P=0.002), and greater lipid core arc (254±66 vs. 222±65°, P=0.027) * * This slide shows the information that can be gathered from IVUS (20Mhz) and from OCT imaging. These are corresponding cross sections within a stent, imaged by both, IVUS in the upper panels and by OCT in the lower panels. The images represent the same spots within a coronary artery (A, B, C) , and illustrate the different quality of information that can be obtained by OCT as compared to conventional grey scale IVUS. In example A, 3 layers of stents can be seen. OCT is able to clearly visualize the individual stent struts, the neotinimal layers separating the different stents and the very thin coverage of the most inner, luminal stent struts. In example B, a bright, eccentric and relatively thick neointimal layer can be seen In example C, again an eccentric neotinimal layer is visible, but please note the completely different , low-reflective and speckled apperance of the neointma. Thus, OCT does not only allow to visualize very thin strut coverage, but also allows to measure the thickness of