光学相干断层成像(OCT)在冠心病(CHD)介入治疗中的临床应用
The Clinical Application of Optical Coherence Tomography (OCT) in Interventional Therapy of Coronary Heart Disease (CHD)
摘要: 近年来，冠心病的患病人数在我国不断上升，对我国人民的生命财产安全造成了巨大危害。经皮冠状动脉介入治疗(PCI)术在缓解心绞痛症状、改善心肌血运重建等方面发挥了重要作用。光学相干断层成像(OCT)以其高达10 μm的分辨率在指导PCI治疗过程中得到了广泛的应用，其不仅可以精准地评估病变斑块的性质、成分和病变部位，还能够通过测量血管管腔的直径、病变长度等指导支架尺寸的选择和着陆点的确定，此外还可以用于支架植入后的优化。
Abstract: In recent years, the number of patients with coronary heart disease has been continuously increasing in China, causing huge harm to the life and property safety of the Chinese people. Percutaneous coronary intervention (PCI) has played an important role in relieving angina pectoris symptoms and improving myocardial revascularization. Optical coherence tomography (OCT), with its resolution as high as 10 μm, has been widely used in guiding the PCI treatment process. It can not only accurately determine the nature, composition and location of the lesion plaque, but also guide the selection of stent size and the determination of the landing point by measuring the diameter of the vascular lumen and the length of the lesion. In addition, it can also be used for optimization after stent implantation.
文章引用：苗官宝. 光学相干断层成像(OCT)在冠心病(CHD)介入治疗中的临床应用[J]. 临床医学进展, 2025, 15(5): 1144-1149. https://doi.org/10.12677/acm.2025.1551476

参考文献

[1] 刘明波, 何新叶, 杨晓红, 等. 《中国心血管健康与疾病报告2023》概要(心血管疾病流行及介入诊疗状况) [J]. 中国介入心脏病学杂志, 2024, 32(10): 541-550.
[2] Teixeira, L., Ferreira, R.O.M., Navalha, D.D.P., Pasqualotto, E., Fae, I.G., Gibicoski, T., et al. (2024) Intravascular Imaging-Guided vs. Angiography-Guided Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis of Randomized Controlled Trials in High-Risk Patients and Complex Coronary Anatomies. International Journal of Cardiology, 416, Article 132510. [Google Scholar] [CrossRef] [PubMed]
[3] Wang, X., Matsumura, M., Mintz, G.S., Lee, T., Zhang, W., Cao, Y., et al. (2017) In vivo Calcium Detection by Comparing Optical Coherence Tomography, Intravascular Ultrasound, and Angiography. JACC: Cardiovascular Imaging, 10, 869-879. [Google Scholar] [CrossRef] [PubMed]
[4] Fujino, A., Mintz, G.S., Matsumura, M., Lee, T., Kim, S., Hoshino, M., et al. (2018) A New Optical Coherence Tomography-Based Calcium Scoring System to Predict Stent Underexpansion. EuroIntervention, 13, 2182-2189. [Google Scholar] [CrossRef] [PubMed]
[5] Matsuhiro, Y., Nakamura, D., Shutta, R., Yanagawa, K., Nakamura, H., Okamoto, N., et al. (2020) Maximum Calcium Thickness Is a Useful Predictor for Acceptable Stent Expansion in Moderate Calcified Lesions. The International Journal of Cardiovascular Imaging, 36, 1609-1615. [Google Scholar] [CrossRef] [PubMed]
[6] Ali, Z.A., Maehara, A., Généreux, P., Shlofmitz, R.A., Fabbiocchi, F., Nazif, T.M., et al. (2016) Optical Coherence Tomography Compared with Intravascular Ultrasound and with Angiography to Guide Coronary Stent Implantation (ILUMIEN III: OPTIMIZE PCI): A Randomised Controlled Trial. The Lancet, 388, 2618-2628. [Google Scholar] [CrossRef] [PubMed]
[7] Ino, Y., Kubo, T., Matsuo, Y., Yamaguchi, T., Shiono, Y., Shimamura, K., et al. (2016) Optical Coherence Tomography Predictors for Edge Restenosis after Everolimus-Eluting Stent Implantation. Circulation: Cardiovascular Interventions, 9, e004231. [Google Scholar] [CrossRef] [PubMed]
[8] Souteyrand, G., Amabile, N., Mangin, L., Chabin, X., Meneveau, N., Cayla, G., et al. (2016) Mechanisms of Stent Thrombosis Analysed by Optical Coherence Tomography: Insights from the National PESTO French Registry. European Heart Journal, 37, 1208-1216. [Google Scholar] [CrossRef] [PubMed]
[9] Adriaenssens, T., Joner, M., Godschalk, T.C., Malik, N., Alfonso, F., Xhepa, E., et al. (2017) Optical Coherence Tomography Findings in Patients with Coronary Stent Thrombosis: A Report of the PRESTIGE Consortium (Prevention of Late Stent Thrombosis by an Interdisciplinary Global European Effort). Circulation, 136, 1007-1021. [Google Scholar] [CrossRef] [PubMed]
[10] Sotomi, Y., Onuma, Y., Dijkstra, J., Miyazaki, Y., Kozuma, K., Tanabe, K., et al. (2017) Fate of Post-Procedural Malapposition of Everolimus-Eluting Polymeric Bioresorbable Scaffold and Everolimus-Eluting Cobalt Chromium Metallic Stent in Human Coronary Arteries: Sequential Assessment with Optical Coherence Tomography in ABSORB Japan Trial. European Heart Journal-Cardiovascular Imaging, 19, 59-66. [Google Scholar] [CrossRef] [PubMed]
[11] Shimamura, K., Kubo, T., Akasaka, T., Kozuma, K., Kimura, K., Kawamura, M., et al. (2014) Outcomes of Everolimus-Eluting Stent Incomplete Stent Apposition: A Serial Optical Coherence Tomography Analysis. European Heart Journal-Cardiovascular Imaging, 16, 23-28. [Google Scholar] [CrossRef] [PubMed]
[12] Wykrzykowska, J.J., Diletti, R., Gutierrez-Chico, J.L., van Geuns, R.J., van der Giessen, W.J., Ramcharitar, S., et al. (2012) Plaque Sealing and Passivation with a Mechanical Self-Expanding Low Outward Force Nitinol Vshield Device for the Treatment of IVUS and Oct-Derived Thin Cap Fibroatheromas (TCFAs) in Native Coronary Arteries: Report of the Pilot Study Vshield Evaluated at Cardiac Hospital in Rotterdam for Investigation and Treatment of TCFA (SECRITT). EuroIntervention, 8, 945-954. [Google Scholar] [CrossRef] [PubMed]
[13] Bezerra, H.G., Attizzani, G.F., Sirbu, V., Musumeci, G., Lortkipanidze, N., Fujino, Y., et al. (2013) Optical Coherence Tomography versus Intravascular Ultrasound to Evaluate Coronary Artery Disease and Percutaneous Coronary Intervention. JACC: Cardiovascular Interventions, 6, 228-236. [Google Scholar] [CrossRef] [PubMed]
[14] Cheneau, E., Leborgne, L., Mintz, G.S., Kotani, J., Pichard, A.D., Satler, L.F., et al. (2003) Predictors of Subacute Stent Thrombosis: Results of a Systematic Intravascular Ultrasound Study. Circulation, 108, 43-47. [Google Scholar] [CrossRef] [PubMed]
[15] Hong, Y.J., Jeong, M.H., Ahn, Y., Sim, D.S., Chung, J.W., Cho, J.S., et al. (2008) Plaque Prolapse after Stent Implantation in Patients with Acute Myocardial Infarction: An Intravascular Ultrasound Analysis. JACC: Cardiovascular Imaging, 1, 489-497. [Google Scholar] [CrossRef] [PubMed]
[16] Kume, T. and Uemura, S. (2017) Current Clinical Applications of Coronary Optical Coherence Tomography. Cardiovascular Intervention and Therapeutics, 33, 1-10. [Google Scholar] [CrossRef] [PubMed]
[17] Räber, L., Mintz, G.S., Koskinas, K.C., Johnson, T.W., Holm, N.R., Onuma, Y., et al. (2018) Clinical Use of Intracoronary Imaging. Part 1: Guidance and Optimization of Coronary Interventions. An Expert Consensus Document of the European Association of Percutaneous Cardiovascular Interventions. European Heart Journal, 39, 3281-3300. [Google Scholar] [CrossRef] [PubMed]
[18] Ono, M., Kawashima, H., Hara, H., Gao, C., Wang, R., Kogame, N., et al. (2020) Advances in IVUS/OCT and Future Clinical Perspective of Novel Hybrid Catheter System in Coronary Imaging. Frontiers in Cardiovascular Medicine, 7, Article 119. [Google Scholar] [CrossRef] [PubMed]
[19] Tian, J., Dauerman, H., Toma, C., Samady, H., Itoh, T., Kuramitsu, S., et al. (2014) Prevalence and Characteristics of TCFA and Degree of Coronary Artery Stenosis: An OCT, IVUS, and Angiographic Study. Journal of the American College of Cardiology, 64, 672-680. [Google Scholar] [CrossRef] [PubMed]
[20] Kubo, T., Akasaka, T. and Guagliumi, G. (2017) Suboptimal Agreement between Optical Coherence Tomography and Near-Infrared Spectroscopy for Identification of Lipid-Laden Plaque. EuroIntervention, 13, 263-264. [Google Scholar] [CrossRef] [PubMed]
[21] Roleder, T., Karimi Galougahi, K., Chin, C.Y., Bhatti, N.K., Brilakis, E., Nazif, T.M., et al. (2016) Utility of Near-Infrared Spectroscopy for Detection of Thin-Cap Neoatherosclerosis. European Heart Journal-Cardiovascular Imaging, 18, 663-669. [Google Scholar] [CrossRef] [PubMed]
[22] Kim, S., Lee, M.W., Kim, T.S., Song, J.W., Nam, H.S., Cho, H.S., et al. (2016) Intracoronary Dual-Modal Optical Coherence Tomography-Near-Infrared Fluorescence Structural-Molecular Imaging with a Clinical Dose of Indocyanine Green for the Assessment of High-Risk Plaques and Stent-Associated Inflammation in a Beating Coronary Artery. European Heart Journal, 37, 2833-2844. [Google Scholar] [CrossRef] [PubMed]

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