Polarimetric signatures of coronary thrombus in patients with acute coronary syndrome

Laurens J.C. van Zandvoort, Kenichiro Otsuka, Martin Villiger, Tara Neleman, Jouke Dijkstra, Felix Zijlstra, Nicolas M. van Mieghem, Brett E. Bouma, Joost Daemen*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Background: Intravascular polarization-sensitive optical frequency domain imaging (PS-OFDI) offers a novel approach to measure tissue birefringence, which is elevated in collagen and smooth muscle cells, that in turn plays a critical role in healing coronary thrombus (HCT). This study aimed to quantitatively assess polarization properties of coronary fresh and organizing thrombus with PS-OFDI in patients with acute coronary syndrome (ACS). Methods and Results: The POLARIS-I prospective registry enrolled 32 patients with ACS. Pre-procedural PS-OFDI pullbacks using conventional imaging catheters revealed 26 thrombus-regions in 21 patients. Thrombus was manually delineated in conventional OFDI cross-sections separated by 0.5 mm and categorized into fresh thrombus caused by plaque rupture, stent thrombosis, or erosion in 18 thrombus-regions (182 frames) or into HCT for 8 thrombus-regions (141 frames). Birefringence of coronary thrombus was compared between the 2 categories. Birefringence in HCTs was significantly higher than in fresh thrombus (∆n=0.47 (0.37–0.72) vs. ∆n=0.25 (0.17–0.29), P=0.007). In a subgroup analysis, when only using thrombus-regions from culprit lesions, ischemic time was a significant predictor for birefringence (ß (∆n)=0.001 per hour, 95% CI [0.0002–0.002], P=0.023). Conclusions: Intravascular PS-OFDI offers the opportunity to quantitatively assess the polarimetric properties of fresh and organizing coronary thrombus, providing new insights into vascular healing and plaque stability.

Original languageEnglish
Pages (from-to)1806-1813
Number of pages8
JournalCirculation Journal
Volume85
Issue number10
DOIs
Publication statusPublished - 24 Sept 2021

Bibliographical note

Funding Information:
Dr. van Zandvoort received institutional research support from Acist Medical Inc. Dr. Otsuka acknowledges partial support from the Japan Heart Foundation / Bayer Yakuhin Research Grant Abroad, the Uehara Memorial Foundation Postdoctoral Fellowship, and the Japan Society for the Promotion of Science Overseas Research Fellowship. Dr. Bouma was supported, in part, by the Professor Andries Querido visiting professorship of the Erasmus University Medical Center in Rotterdam. Dr. Daemen reports to have received institutional research support from Pie Medical, Acist Medical Inc., PulseCath, Medtronic, Boston Scientific, Abbott Vascular and speaker and consultancy fees from PulseCath, Medtronic, ReCor Medical, Acist Medical Inc.

Funding Information:
Massachusetts General Hospital and the Erasmus University Medical Center have patent licensing arrangements with Terumo Corporation. The Wellman center received institutional support from Terumo Corporation. This work was supported by the National Institutes of Health (grants P41EB-015903 and R01HL-119065) and by Terumo Corporation.

Publisher Copyright:
© 2021 Japanese Circulation Society. All rights reserved.

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