OCT-based quantitative predictors of coronary dissection during rotational atherectomy in severe calcified lesions
BackgroundIn the treatment of coronary calcification by rotational atherectomy (ROTA), guidewire bias is often considered to lead to procedure-associated coronary dissections or perforations. However, the actual meaning of guidewire bias is unclear, though it usually refers to the cross-sectional lo...
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Frontiers Media S.A.
2025-08-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2025.1640237/full |
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| author | Yu-he Zhou Hong-li Zhang Yang Yang Mei-qin Wang Jun Pan Tian Xu Pei-na Meng Fei Ye Yan-qing Wang |
| author_facet | Yu-he Zhou Hong-li Zhang Yang Yang Mei-qin Wang Jun Pan Tian Xu Pei-na Meng Fei Ye Yan-qing Wang |
| author_sort | Yu-he Zhou |
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| description | BackgroundIn the treatment of coronary calcification by rotational atherectomy (ROTA), guidewire bias is often considered to lead to procedure-associated coronary dissections or perforations. However, the actual meaning of guidewire bias is unclear, though it usually refers to the cross-sectional location of the intravascular imaging (IVI) catheter in the coronary artery. This study tentatively explores the quantitative criteria in optical coherence tomography (OCT) imaging of guidewire bias, which may cause ROTA-induced coronary dissection.MethodsA total of 21 patients with severe calcified coronary lesions who underwent ROTA treatment were enrolled in our study. OCT successfully detected these patients pre-ROTA and post-ROTA. All observed coronary segments were analyzed cross-sectionally at every 1-mm interval after manual coregistration of pre-ROTA and post-ROTA OCT images. ROTA-related coronary dissection was the primary endpoint.ResultsA total of 388 OCT cross-sectional images were effectively measured and analyzed to assess the distribution and characteristics of plaque and OCT catheter location pre-ROTA, as well as the presence or absence of coronary dissections post-ROTA after manual coregistration. According to the receiver operating characteristic (ROC) analysis, the distance from the center of OCT catheter to the media at the bias direction (Dcmb) (area under the curve (AUC): 1.000, p < 0.001, 95% confidence intervals (CI): 0.999–1.000) and the touch angle (AUC: 0.988, p < 0.001, 95%CI: 0.968 to 1.000) were strongly correlated with ROTA-related coronary dissection, with the corresponding cutoff values of 0.720 mm and 98.2° respectively.ConclusionDcmb and touch angle detected by OCT are two valuable and convenient independent predictors of ROTA-related coronary intimal dissections caused by guidewire bias. |
| format | Article |
| id | doaj-art-60aff4b1017c4d638e044a84a1fe3484 |
| institution | Kabale University |
| issn | 2296-858X |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Medicine |
| spelling | doaj-art-60aff4b1017c4d638e044a84a1fe34842025-08-20T04:03:21ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-08-011210.3389/fmed.2025.16402371640237OCT-based quantitative predictors of coronary dissection during rotational atherectomy in severe calcified lesionsYu-he Zhou0Hong-li Zhang1Yang Yang2Mei-qin Wang3Jun Pan4Tian Xu5Pei-na Meng6Fei Ye7Yan-qing Wang8Department of General Practice, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, ChinaThe Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, ChinaDepartment of General Practice, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, ChinaDepartment of General Practice, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, ChinaDepartment of General Practice, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, ChinaDivision of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, ChinaDivision of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, ChinaDivision of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, ChinaDepartment of General Practice, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, ChinaBackgroundIn the treatment of coronary calcification by rotational atherectomy (ROTA), guidewire bias is often considered to lead to procedure-associated coronary dissections or perforations. However, the actual meaning of guidewire bias is unclear, though it usually refers to the cross-sectional location of the intravascular imaging (IVI) catheter in the coronary artery. This study tentatively explores the quantitative criteria in optical coherence tomography (OCT) imaging of guidewire bias, which may cause ROTA-induced coronary dissection.MethodsA total of 21 patients with severe calcified coronary lesions who underwent ROTA treatment were enrolled in our study. OCT successfully detected these patients pre-ROTA and post-ROTA. All observed coronary segments were analyzed cross-sectionally at every 1-mm interval after manual coregistration of pre-ROTA and post-ROTA OCT images. ROTA-related coronary dissection was the primary endpoint.ResultsA total of 388 OCT cross-sectional images were effectively measured and analyzed to assess the distribution and characteristics of plaque and OCT catheter location pre-ROTA, as well as the presence or absence of coronary dissections post-ROTA after manual coregistration. According to the receiver operating characteristic (ROC) analysis, the distance from the center of OCT catheter to the media at the bias direction (Dcmb) (area under the curve (AUC): 1.000, p < 0.001, 95% confidence intervals (CI): 0.999–1.000) and the touch angle (AUC: 0.988, p < 0.001, 95%CI: 0.968 to 1.000) were strongly correlated with ROTA-related coronary dissection, with the corresponding cutoff values of 0.720 mm and 98.2° respectively.ConclusionDcmb and touch angle detected by OCT are two valuable and convenient independent predictors of ROTA-related coronary intimal dissections caused by guidewire bias.https://www.frontiersin.org/articles/10.3389/fmed.2025.1640237/fullrotational atherectomyguidewire biascoronary dissectionoptical coherence tomographypredictive index |
| spellingShingle | Yu-he Zhou Hong-li Zhang Yang Yang Mei-qin Wang Jun Pan Tian Xu Pei-na Meng Fei Ye Yan-qing Wang OCT-based quantitative predictors of coronary dissection during rotational atherectomy in severe calcified lesions Frontiers in Medicine rotational atherectomy guidewire bias coronary dissection optical coherence tomography predictive index |
| title | OCT-based quantitative predictors of coronary dissection during rotational atherectomy in severe calcified lesions |
| title_full | OCT-based quantitative predictors of coronary dissection during rotational atherectomy in severe calcified lesions |
| title_fullStr | OCT-based quantitative predictors of coronary dissection during rotational atherectomy in severe calcified lesions |
| title_full_unstemmed | OCT-based quantitative predictors of coronary dissection during rotational atherectomy in severe calcified lesions |
| title_short | OCT-based quantitative predictors of coronary dissection during rotational atherectomy in severe calcified lesions |
| title_sort | oct based quantitative predictors of coronary dissection during rotational atherectomy in severe calcified lesions |
| topic | rotational atherectomy guidewire bias coronary dissection optical coherence tomography predictive index |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2025.1640237/full |
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