Key result
Optical coherence tomography light intensity ratios could not predict erythrocyte or platelet content, failing to differentiate between red and white thrombi or determine thrombus age in STEMI patients.
Why the study?
STEMI is caused by occlusive coronary thrombosis, and whether thrombus can be characterized by erythrocyte content and age using intravascular OCT in a clinical setting was unknown.
Does intravascular optical coherence tomography (OCT) accurately characterize thrombus erythrocyte content and age compared to histomorphology in STEMI patients?
Observational (n=66)
No
Does intravascular optical coherence tomography (OCT) accurately characterize thrombus erythrocyte content and age compared to histomorphology in STEMI patients?
Intravascular OCT is unable to reliably differentiate between red and white thrombi or determine thrombus age in patients with STEMI.
OCT cannot differentiate thrombus types or age in STEMI; leaves open need for validated imaging alternatives in research.
AIMS: ST elevation myocardial infarction (STEMI) is caused by an occlusive thrombosis of a coronary artery. We wanted to assess if the thrombus can be characterized according to erythrocyte content and age using intravascular optical coherence tomography (OCT) in a clinical setting. METHODS AND RESULTS: We performed manual thrombus aspiration in 66 STEMI patients. OCT was done of the thrombus remnants after aspiration. A light intensity ratio was measured through the thrombus. Forty two of the aspirates had thrombus which could be analyzed histomorphologically for analysis of erythrocyte and platelet content, and to determine the age of thrombus as fresh, lytic or organized. There were 11 red, 21 white and 10 mixed thrombi. Furthermore, 36 aspirates had elements of fresh, 7 of lytic and 8 of organized thrombi. There was no correlation between colour and age. OCT appearance could not predict erythrocyte or platelet content. The light intensity ratios were not significantly different in fresh, lytic or organized thrombi. CONCLUSION: OCT could not differentiate between red and white thrombi, nor determine thrombus age.
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Eriksen et al. (2022) conducted an observational in ST elevation myocardial infarction (STEMI) (n=66). Optical coherence tomography (OCT) vs. Histomorphological evaluation was evaluated on Loss of backscattered light through coronary thrombi (light intensity ratio) to differentiate red and white thrombi (p=0.41). Optical coherence tomography light intensity ratios could not predict erythrocyte or platelet content, failing to differentiate between red and white thrombi or determine thrombus age in STEMI patients.
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