Reproducibility of optical coherence tomography in vein grafts used for coronary revascularization
Abstract
Background: Optical coherence tomography (OCT) is a high-resolution imaging modality able to provide near-histological images of vessel walls making it possible to distinguish intima and media layers of the vessel wall separately. The use of this imaging technique is increasing while data on the variability and reliability is lacking. The aim of this study was to investigate the reproducibility of frequency-domain OCT in vein grafts used for coronary revascularization.
Methods: Five pullbacks were analyzed by the same analyst with a 1-month delay (intraobserver) and by two different analysts (interobserver). Five pairs of pullbacks from the same catheters and vein graft were also analyzed (inter pullback).
Results: Optical coherence tomography showed low variability in intra- and interobserver analysis with relative differences of mean media and intima thicknesses and areas of less than 5% for most parameters.
Relative differences of the same parameters in the inter pullback analysis were in the 5–15% range. Intra- and interobserver reliability was excellent (intraclass correlation coefficient [ICC] > 0.90) for intima thickness and intima, media and intima-media area measurements. Inter pullback reliability was good (ICC: 0.75–0.90) for intima and intima-media area measurements, and moderate to good for mean intima thickness measurements (ICC: 0.79; 0.7338–0.8284).
Conclusions: Optical coherence tomography provides good reproducibility for the measurements of parameters relevant for the development of atherosclerosis in vein grafts.
Clinical trial registration: ID NCT01834846.
Keywords: coronary artery diseasesaphenous vein graftintimal hyperplasia
References
- Tearney GJ, Regar E, Akasaka T, et al. Consensus standards for acquisition, measurement, and reporting of intravascular optical coherence tomography studies: a report from the International Working Group for Intravascular Optical Coherence Tomography Standardization and Validation. J Am Coll Cardiol. 2012; 59(12): 1058–72.
- Zivelonghi C, Ghione M, Kilickesmez K, et al. Intracoronary optical coherence tomography: a review of clinical applications. J Cardiovasc Med (Hagerstown). 2014; 15(7): 543–553.
- Une D, Kulik A, Voisine P, et al. Correlates of saphenous vein graft hyperplasia and occlusion 1 year after coronary artery bypass grafting: analysis from the CASCADE randomized trial. Circulation. 2013; 128(11 Suppl 1): S213–S218.
- Kaneda H, Terashima M, Takahashi T, et al. Mechanisms of lumen narrowing of saphenous vein bypass grafts 12 months after implantation: an intravascular ultrasound study. Am Heart J. 2006; 151(3): 726–729.
- Wakeyama T, Ogawa H, Iida H, et al. Intima-media thickening of the radial artery after transradial intervention. J Am Coll Cardiol. 2003; 41(7): 1109–1114.
- American College of Cardiology Clinical Expert Consensus Document on Standards for Acquisition, Measurement and Reporting of Intravascular Ultrasound Studies (IVUS). A report of the American College of Cardiology Task Force on Clinical Expert Consensus Documents developed in collaboration with the European Society of Cardiology endorsed by the Society of Cardiac Angiography and Interventions. Eur J Echocardiogr. 2001; 2(4): 299–313.
- Kubo T, Akasaka T, Shite J, et al. OCT compared with IVUS in a coronary lesion assessment: the OPUS-CLASS study. JACC Cardiovasc Imaging. 2013; 6(10): 1095–1104.
- Antonsen L, Thayssen P, Junker A, et al. Intra- and interobserver reliability and intra-catheter reproducibility using frequency domain optical coherence tomography for the evaluation of morphometric stent parameters and qualitative assessment of stent strut coverage. Cardiovasc Revasc Med. 2015; 16(8): 469–477.
- Gerbaud E, Weisz G, Tanaka A, et al. Multi-laboratory inter-institute reproducibility study of IVOCT and IVUS assessments using published consensus document definitions. Eur Heart J Cardiovasc Imaging. 2016; 17(7): 756–764.
- Fedele S, Biondi-Zoccai G, Kwiatkowski P, et al. Reproducibility of coronary optical coherence tomography for lumen and length measurements in humans (The CLI-VAR [Centro per la Lotta contro l'Infarto-VARiability] study). Am J Cardiol. 2012; 110(8): 1106–1112.
- Burris N, Schwartz K, Tang CM, et al. Catheter-based infrared light scanner as a tool to assess conduit quality in coronary artery bypass surgery. J Thorac Cardiovasc Surg. 2007; 133(2): 419–427.
- Meirson T, Orion E, Di Mario C, et al. Flow patterns in externally stented saphenous vein grafts and development of intimal hyperplasia. J Thorac Cardiovasc Surg. 2015; 150(4): 871–878.
- Brown EN, Burris NS, Gu J, et al. Thinking inside the graft: applications of optical coherence tomography in coronary artery bypass grafting. J Biomed Opt. 2007; 12(5): 051704.
- Pettersen Ø, Wiseth R, Hegbom K, et al. Pedicled Vein Grafts in Coronary Surgery Exhibit Reduced Intimal Hyperplasia at 6 Months. J Am Coll Cardiol. 2016; 68(4): 427–429.
- Pettersen Ø, Haram PM, Winnerkvist A, et al. Pedicled Vein Grafts in Coronary Surgery: Perioperative Data From a Randomized Trial. Ann Thorac Surg. 2017; 104(4): 1313–1317.
- Prati F, Guagliumi G, Mintz GS, et al. Expert's OCT Review Document. Expert review document part 2: methodology, terminology and clinical applications of optical coherence tomography for the assessment of interventional procedures. Eur Heart J. 2012; 33(20): 2513–2520.
- Prati F, Regar E, Mintz GS, et al. Expert's OCT Review Document. Expert review document on methodology, terminology, and clinical applications of optical coherence tomography: physical principles, methodology of image acquisition, and clinical application for assessment of coronary arteries and atherosclerosis. Eur Heart J. 2010; 31(4): 401–415.
- Shrout P, Fleiss J. Intraclass correlations: Uses in assessing rater reliability. Psychological Bulletin. 1979; 86(2): 420–428.
- McGraw K, Wong SP. Forming inferences about some intraclass correlation coefficients. Psychological Methods. 1996; 1(1): 30–46.
