Identifying Thin-Cap Fibroatheroma: Virtual-Histology Intravascular Ultrasound or Optical Coherence Tomography?

Studies have shown that two-thirds of all myocardial infarctions are caused by the rupture of plaques with large lipid content and necrotic core (NC), resulting in luminal thrombosis. Thin-cap fibroatheroma (TCFA) are characterized as a presence of a large lipid pool with overlying thin fibrous cap (<65 μm) and is associated with future major adverse cardiovascular events. The diagnosis requires a high spatial resolution (axial,lateral, elevation) and temporal.

Brown and colleagues conducted a study in 258 regions of interest from autopsied human hearts, with plaque composition and classification assessed by histology and compared with coregistered ex vivo VH-IVUS and OCT. Sixty-seven regions of interest were classified as fibroatheroma on histology, with 22 meeting criteria for TCFA. On VH-IVUS, plaque (10.91 ± 4.82 versus 8.42 ± 4.57 mm²; P=0.01) and necrotic core areas (1.59 ± 0.99 versus 1.03 ± 0.85 mm²; P=0.02) were increased in TCFA versus other fibroatheroma. Read more>>>>>>>>>>>>>>