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<p>In Japan, the current indication for intravascular lithotripsy (IVL) in percutaneous coronary intervention (PCI) is based on the intravascular ultrasound (IVUS) or optical coherence tomography (OCT) calcium score of ≥ 3. We aimed to investigate a new IVUS-based criterion equivalent to OCT calcium scores. We retrospectively analyzed 110 cases with moderate or severe calcification on angiography, along with analyzable pre-PCI OCT or optical frequency domain imaging and simultaneous pre-/post-PCI IVUS. For the transition from the OCT calcium score to the IVUS-based approach, we used the cutoff value of receiver operating characteristic analyses. OCT-derived maximum calcium angle &gt; 180° was replaced by the IVUS-derived maximum calcium angle &gt; 225°, and the OCT-derived calcium length &gt; 5.0&#xa0;mm was replaced by the IVUS-derived calcium angle &gt; 180° in &gt; 3&#xa0;mm length. The IVUS-derived maximum calcium angle &gt; 225° was equivalent to the OCT calcium score ≥ 3 (positive predictive value of 0.972), and meeting both IVUS surrogate markers was equivalent to that of 4 (positive predictive value of 0.982). Patients with the IVUS-derived maximum calcium angle &gt; 225° or meeting both IVUS surrogate markers had a higher incidence of stent underexpansion at the maximum calcification site (10.9% versus 0%, <i>p</i> = 0.044; or 12.8% versus 1.8%, <i>p</i> = 0.046, respectively). An IVUS-derived maximum calcium angle &gt; 225° or meeting both the IVUS-derived maximum calcium angle &gt; 225° and the IVUS-derived calcium angle &gt; 180° in &gt; 3&#xa0;mm length could provide a useful alternative to OCT calcium score of ≥ 3 or 4 and could predict stent underexpansion at the maximum calcification site.</p> Graphical abstract <p></p>

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Intravascular ultrasound surrogate markers for optical coherence tomography calcium score in percutaneous coronary intervention

  • 期刊论文

  • 发表日期：

    2026年1月20日

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  • Kyoko Hattori,
  • Masaomi Gohbara,
  • Shun Kitajima,
  • Yohei Hanajima,
  • Katsuhiko Tsutsumi,
  • Hidekuni Kirigaya,
  • Jin Kirigaya,
  • Shinnosuke Kikuchi,
  • Hidefumi Nakahashi,
  • Yuichiro Kimura,
  • Kensuke Matsushita,
  • Kozo Okada,
  • Noriaki Iwahashi,
  • Masami Kosuge,
  • Teruyasu Sugano,
  • Toshiaki Ebina,
  • Kiyoshi Hibi

摘要

In Japan, the current indication for intravascular lithotripsy (IVL) in percutaneous coronary intervention (PCI) is based on the intravascular ultrasound (IVUS) or optical coherence tomography (OCT) calcium score of ≥ 3. We aimed to investigate a new IVUS-based criterion equivalent to OCT calcium scores. We retrospectively analyzed 110 cases with moderate or severe calcification on angiography, along with analyzable pre-PCI OCT or optical frequency domain imaging and simultaneous pre-/post-PCI IVUS. For the transition from the OCT calcium score to the IVUS-based approach, we used the cutoff value of receiver operating characteristic analyses. OCT-derived maximum calcium angle > 180° was replaced by the IVUS-derived maximum calcium angle > 225°, and the OCT-derived calcium length > 5.0 mm was replaced by the IVUS-derived calcium angle > 180° in > 3 mm length. The IVUS-derived maximum calcium angle > 225° was equivalent to the OCT calcium score ≥ 3 (positive predictive value of 0.972), and meeting both IVUS surrogate markers was equivalent to that of 4 (positive predictive value of 0.982). Patients with the IVUS-derived maximum calcium angle > 225° or meeting both IVUS surrogate markers had a higher incidence of stent underexpansion at the maximum calcification site (10.9% versus 0%, p = 0.044; or 12.8% versus 1.8%, p = 0.046, respectively). An IVUS-derived maximum calcium angle > 225° or meeting both the IVUS-derived maximum calcium angle > 225° and the IVUS-derived calcium angle > 180° in > 3 mm length could provide a useful alternative to OCT calcium score of ≥ 3 or 4 and could predict stent underexpansion at the maximum calcification site.

Graphical abstract