Advantage of Next-Generation Frequency-Domain Optical Coherence Tomography Compared with Conventional Time-Domain System in the Assessment of Coronary Lesion

Background: Intracoronary optical coherence tomography (OCT) is a high-resolution imaging modality used for evaluation of coronary lesion morphology. However, current time-domain OCT (TD-OCT) have a number of limitations with regard to both procedural usage and safety in the clinical setting. The next-generation frequency-domain OCT (FD-OCT), which has a much faster frame rate and pullback speed than TD-OCT, is expected to overcome these limitations. The aim of this study was to evaluate the feasibility and usability of next generation FD-OCT in the assessment of coronary lesions. Methods: A comparison study was performed between FD-OCT and TD-OCT from the aspect of usability (set-up time), qualitatively (rate of clear image segment), and safety (adverse event) in 14 ischemic heart disease patients with 20 previously implanted coronary stents. Results: The mean time of the OCT procedure in this study from setup to completion of image acquisition was 3.2 +/- 0.8 min for FD-OCT and 11.2 +/- 2.5 min for TD-OCT (P < 0.01). In qualitative image assessment, FD-OCT has the potential to yield a higher rate of clear image segments (CIS) than TD-OCT (99.4% vs. 80.8%, respectively; P < 0.01). In addition to these improved characteristics, there were no ischemic ECG changes or arrhythmia associated with FD-OCT. Conclusions: The next-generation intracoronary FD-OCT has better performance in the clinical setting and the potential to overcome several limitations of conventional TD-OCT systems. (C) 2009 Wiley-Liss, Inc.