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Assessment of coronary arterial thrombus by optical coherence tomography

Teruyoshi Kume1, Takashi Akasaka, Takahiro Kawamoto

  • 1Department of Cardiology, Kawasaki Medical School, Kurashiki, Japan. tteru@med.kawasaki-m.ac

The American Journal of Cardiology
|June 13, 2006
PubMed

Insights

Optical coherence tomography (OCT) can differentiate red and white coronary thrombi based on signal intensity attenuation width. This method offers a new way to analyze thrombus characteristics in postmortem examinations.

Area of Science:

  • Cardiovascular Pathology
  • Medical Imaging

Background:

  • Coronary thrombi are critical in cardiovascular disease.
  • Histologic examination is the gold standard for thrombus classification.
  • Optical coherence tomography (OCT) provides high-resolution intravascular imaging.

Purpose of the Study:

  • To analyze and differentiate optical coherence tomographic (OCT) characteristics of red and white coronary thrombi.
  • To establish OCT parameters for distinguishing between red and white thrombi in postmortem coronary arteries.

Main Methods:

  • Analysis of 108 coronary arterial segments from 40 human cadavers using OCT.
  • Acquisition and intensity property analysis of OCT images for red and white thrombi.
  • Measurement of peak intensity and 1/2 signal intensity attenuation width.

Main Results:

  • Red and white thrombi were identified in 17% and 18% of segments, respectively.
  • No significant difference in peak OCT signal intensity between red and white thrombi.
  • Significant difference in 1/2 signal intensity attenuation width (324±50 µm for red vs. 183±42 µm for white thrombi; p<0.0001).
  • A cut-off value of 250 µm for 1/2 width differentiated thrombus types with 90% sensitivity and 88% specificity.

Conclusions:

  • OCT imaging reveals distinct characteristics for red and white coronary thrombi.
  • Signal intensity attenuation width is a key parameter for differentiating thrombus types.
  • OCT shows potential for non-invasive characterization of coronary thrombi, aiding in plaque morphology assessment.

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