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. 2022 Apr 11;17(4):e0266634.
doi: 10.1371/journal.pone.0266634. eCollection 2022.

Thrombus characteristics evaluated by acute optical coherence tomography in ST elevation myocardial Infarction

Erlend Eriksen  1   2 , Jon Herstad  1 , Kartika Ratna Pertiwi  3 , Vegard Tuseth  1   2 , Jan Erik Nordrehaug  2 , Øyvind Bleie  1 , Allard C van der Wal  3
Affiliations

Thrombus characteristics evaluated by acute optical coherence tomography in ST elevation myocardial Infarction

Erlend Eriksen et al. PLoS One. .

Abstract

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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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flowchart.
Fig 2
Fig 2. Comparison between ratio of lightloss measured by Ilumien Optis and ImageJ softwares with correlation 0,40 (p = 0,0001).
Fig 3
Fig 3. Ratio of lightloss by Ilumien Optis software in the different histopathological defined colours.
Fig 4
Fig 4. Ratio of lightloss by Ilumien Optis software in thrombi defined by histopathological appearance.
Fig 5
Fig 5
The same thrombus (arrow) as it appears on ImageJ (A) and Ilumien Optis (B) softwares. Thrombus protruding towards catheter appears compressed in ImageJ (A). Size of ROI (Region of Interest) showed in red figures (a = small ROI, b = large ROI, c = freehand ROI). Ratio of lightloss in these images was 1.02 by ImageJ and 0.64 by Ilumien Optis. Diameter of catheter is 0.914 microns.
Fig 6
Fig 6
Representative image of fresh thrombus, classified as a red thrombus (in this case 80% of erythrocytes) in HE staining (A), red area represents erythrocytes; Inset: a higher magnification image (B) showing the interface of small area of platelet aggregates (pale pink staining) with red blood cells and granulocytes (dark purple nucleated cells). Images are from the same patient as Fig 5. Bar scale in A: 200 μm and in B: 25 μm.
See this image and copyright information in PMC

References

    1. Ibanez B, James S, Agewall S, Antunes MJ, Bucciarelli-Ducci C, Bueno H, et al.. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). European heart journal. 2018;39(2):119–77. doi: 10.1093/eurheartj/ehx393 - DOI - PubMed
    1. George JC, Dangas GD, American Heart A, American College of C. 2009 Focused updates to guidelines in ST-elevation myocardial infarction and percutaneous coronary intervention: application to interventional cardiology. JACC Cardiovascular interventions. 2010;3(2):256–8. doi: 10.1016/j.jcin.2010.01.004 - DOI - PubMed
    1. van der Wal AC, Becker AE. Atherosclerotic plaque rupture—pathologic basis of plaque stability and instability. Cardiovascular research. 1999;41(2):334–44. doi: 10.1016/s0008-6363(98)00276-4 - DOI - PubMed
    1. Rittersma SZ, van der Wal AC, Koch KT, Piek JJ, Henriques JP, Mulder KJ, et al.. Plaque instability frequently occurs days or weeks before occlusive coronary thrombosis:a pathological thrombectomy study in primary percutaneous coronary intervention. Circulation.2005;111(9):1160–5. doi: 10.1161/01.CIR.0000157141.00778.AC - DOI - PubMed
    1. Kramer MC, van der Wal AC, Koch KT, Ploegmakers JP, van der Schaaf RJ, Henriques JP, et al.. Presence of older thrombus is an independent predictor of long-term mortality in patients with ST-elevation myocardial infarction treated with thrombus aspiration during primary percutaneous coronary intervention. Circulation. 2008;118(18):1810–6. doi: 10.1161/CIRCULATIONAHA.108.780734 - DOI - PubMed

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