Serial optical coherence tomography imaging of ACS-causing culprit plaques

EuroIntervention. 2015 Jul;11(3):319-24. doi: 10.4244/EIJV11I3A59.

Abstract

Aims: The aim of this study was to understand better the mechanisms of repair of plaque complications causing acute coronary syndrome.

Methods and results: We used OCT in the acute phase and at follow-up (one to seven months) to investigate the plaque healing in 10 culprit plaques: five ruptured fibrous cap (RFC) and five intact fibrous cap (IFC) which were not treated with stent deployment and caused ST-segment elevation myocardial infarction (n=8) and non-STEMI (n=2). At follow-up OCT, the margins of the evacuated cavity in RFC plaques showed a smooth surface and a morphology similar to that of baseline images, while IFC plaques showed a smoothened intimal border and a double layering indicating organising thrombus incorporated in the superficial layers of the plaque.

Conclusions: In the months following a successfully dissolved acute thrombosis, OCT revealed that the cavity of RFC plaques persists and is bordered by a smooth "neointima", while IFC plaques showed features suggesting partial incorporation of the deepest layers of thrombus in the plaque.

MeSH terms

  • Acute Coronary Syndrome / complications
  • Acute Coronary Syndrome / diagnosis
  • Acute Coronary Syndrome / surgery*
  • Adult
  • Aged
  • Coronary Angiography / methods
  • Humans
  • Male
  • Middle Aged
  • Plaque, Atherosclerotic / diagnosis
  • Plaque, Atherosclerotic / etiology
  • Plaque, Atherosclerotic / surgery*
  • Rupture, Spontaneous / surgery*
  • Tomography, Optical Coherence*
  • Treatment Outcome