Comparison between Preoperative Optical Coherence Tomography Findings of Carotid Artery Stenosis and Pathological Specimen of Removed Carotid Plaque: Case Report

抄録

Objective: Optical coherence tomography (OCT) has recently been applied for the characterization of carotid plaques, but few studies have compared OCT findings with findings from histopathologic examination of carotid plaques. We consider the accuracy, problems, and limitation of OCT findings by comparing OCT findings of carotid artery stenosis and pathological specimen of removed carotid plaque, and confirm that the interpretation of coronary artery findings of OCT can be applied to OCT findings of carotid artery plaque.

Case Presentation: A 63-year-old man with asymptomatic left carotid stenosis underwent carotid endarterectomy (CEA). Findings for histopathologic assessment of excised plaque were compared with those from preoperative OCT images at the same section levels. Preoperative OCT findings of carotid artery stenosis were similar to histopathologic examination of carotid plaques removed by CEA. This suggests that OCT has great ability to visualize pathological fibrous cap and ulceration and to visualize the structure of neovascularization in the neointima. However, OCT was unable to differentiate between lesions that were visualized in histopathological examination as lipid component, hemorrhagic transformation, and necrotic transformation.

Conclusion: The high resolution of OCT enables real-time acquisition of carotid plaque data. Although OCT is invasive examination, it may contribute to the evaluation of carotid plaque characterization.