Assessment of Culprit Lesion Morphology in Acute Myocardial InfarctionAbility of Optical Coherence Tomography Compared With Intravascular Ultrasound and Coronary Angioscopy
Takashi Kubo, MD, PhD,
Toshio Imanishi, MD, PhD,
Shigeho Takarada, MD, PhD,
Akio Kuroi, MD,
Satoshi Ueno, MD,
Takashi Yamano, MD,
Takashi Tanimoto, MD,
Yoshiki Matsuo, MD, PhD,
Takashi Masho, MD,
Hironori Kitabata, MD,
Kazushi Tsuda, MD, PhD,
Yoshiaki Tomobuchi, MD, PhD and
Takashi Akasaka, MD, PhD*
Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan.
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Figure 1 Images of Typical Fibrous Cap Disruption
Fibrous cap disruption in corresponding images of optical coherence tomography (A), coronary angioscopy (B), and intravascular ultrasound (C). (A) Lipid-rich plaque (L) with localized disruption of a fibrous cap with a flap protruding into lumen (arrow). (B) Yellow lesion with fibrous cap disruption (arrows) and large ulceration (U). (C) Eccentric plaque ruptured at the shoulder (arrow).
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Figure 2 Images of Typical Fibrous Cap Erosion
Fibrous cap erosion in corresponding images of optical coherence tomography (A), coronary angioscopy (B), and intravascular ultrasound (C). (A) Erosion located on the surface of a plaque (arrows) with intraluminal thrombus (T). (B) Rough surface erosion without disrupted fibrous cap protruding into lumen (arrows). (C) No identification of fibrous cap erosion.
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Figure 3 Images of Typical Intraluminal Thrombi
Intraluminal thrombi in corresponding images of optical coherence tomography (A), coronary angioscopy (B), and intravascular ultrasound (C). (A) Thrombus with optical coherence tomography signal attenuation (T). (B) Large white thrombus (WT) and small red thrombus (RT) adhering to a rough surface of yellow plaque. (C) Thrombus (arrows) identified the mass images protruding into the vessel lumen from the surface of the vessel wall.
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Figure 4 Measurement of Fibrous Cap Thickness
Measurement of fibrous cap thickness in ruptured plaque using optical coherence tomography. Residual fibrous cap was identified as a flap between the lumen of the coronary artery and the cavity of plaque, and its thickness was measured at the thinnest part (arrows). Scale bar = 1 mm.
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