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Cardiac Magnetic Resonance for the Evaluation of Suspected Cardiac Thrombus: Conventional and Emerging Techniques
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Cardiac Magnetic Resonance for the Evaluation of Suspected Cardiac Thrombus: Conventional and Emerging Techniques

Published on: June 11, 2019

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Thrombus characteristics evaluated by acute optical coherence tomography in ST elevation myocardial Infarction

Erlend Eriksen1,2, Jon Herstad1, Kartika Ratna Pertiwi3

  • 1Department of Heart Disease, Haukeland University Hospital, Bergen, Norway.

Plos One
|April 11, 2022
PubMed

Insights

Optical coherence tomography (OCT) cannot distinguish red from white thrombi or determine thrombus age in ST-elevation myocardial infarction (STEMI) patients. This imaging technique lacks the resolution for detailed thrombus characterization.

Area of Science:

  • Cardiovascular Medicine
  • Medical Imaging
  • Interventional Cardiology

Background:

  • ST-elevation myocardial infarction (STEMI) results from occlusive coronary artery thrombosis.
  • Characterizing thrombus composition and age is crucial for understanding myocardial infarction pathophysiology.
  • Intravascular imaging modalities are being explored for in-situ thrombus assessment.

Purpose of the Study:

  • To evaluate the utility of intravascular optical coherence tomography (OCT) for characterizing thrombus erythrocyte content and age in STEMI patients.
  • To determine if OCT imaging can differentiate between red and white thrombi.
  • To assess if OCT can predict thrombus age (fresh, lytic, organized).

Main Methods:

  • Manual thrombus aspiration was performed in 66 STEMI patients.
  • Thrombus remnants were analyzed using intravascular OCT.
  • Histomorphological analysis assessed erythrocyte and platelet content and thrombus age.
  • Light intensity ratios were measured through the thrombus via OCT.

Main Results:

  • Histomorphological analysis identified 11 red, 21 white, and 10 mixed thrombi.
  • Thrombus age analysis revealed 36 fresh, 7 lytic, and 8 organized thrombi.
  • No significant correlation was found between thrombus color and age.
  • OCT appearance did not predict erythrocyte or platelet content.
  • Light intensity ratios did not differ significantly between fresh, lytic, or organized thrombi.

Conclusions:

  • Intravascular OCT is unable to differentiate between red and white thrombi.
  • OCT imaging cannot reliably determine the age of coronary thrombi in STEMI.
  • Current OCT technology is insufficient for detailed in-situ thrombus characterization based on composition and age.
Abstract

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