Anatomically correct three-dimensional coronary artery reconstruction using frequency domain optical coherence tomographic and angiographic data: head-to-head comparison with intravascular ultrasound for endothelial shear stress assessment in humans

作者：Papafaklis Michail I; Bourantas Christos V; Yonetsu Taishi; Vergallo Rocco; Kotsia Anna; Nakatani Shimpei; Lakkas Lampros S; Athanasiou Lambros S; Naka Katerina K; Fotiadis Dimitrios I; Feldman Charles L; Stone Peter H; Serruys Patrick W; Jang Ik Kyung; Michalis Lampros K^*

来源：Eurointervention, 2015, 11(4): 407-415.

DOI：10.4244/EIJY14M06_11

• angiography
• endothelial shear stress
• intravascular ultrasound
• optical coherence tomography
• three-dimensional reconstruction

Aims: To develop a methodology that permits accurate 3-dimensional (3D) reconstruction from FD-OCT and angiographic data enabling reliable evaluation of the ESS distribution, and to compare the FD-OCT-derived models against the established models based on angiography/IVUS.
Methods and results: Fifteen patients (17 coronary arteries) who underwent angiography, FD-OCT and IVUS examination during the same procedure were studied. The FD-OCT and IVUS lumen borders were placed onto the 3D luminal centreline derived from angiographic data. Three-dimensional geometry algorithms and anatomical landmarks were used to estimate the orientation of the borders appropriately. ESS was calculated using computational fluid dynamics. In 188 corresponding consecutive 3-mm segments, FD-OCTand IVUS-derived models were highly correlated for lumen area (r=0.96) and local ESS (r=0.89) measurements. FD-OCT-based 3D reconstructions had a high diagnostic accuracy for detecting regions exposed to proatherogenic low ESS identified on the IVUS-based 3D models, considered as the gold standard (receiver operator characteristic area under the curve: 94.9%).
Conclusions: FD-OCT-based 3D coronary reconstruction provides anatomically correct models and permits reliable ESS computation. ESS assessment in combination with the superior definition of plaque characteristics by FD-OCT is expected to provide valuable insights into the effect of the haemodynamic environment on the development and destabilisation of high-risk plaques.

• 出版日期2015-8