Prospective Evaluation of Optical Coherence Tomography in Lower Limb Arteries Compared with Intravascular Ultrasound

Abstract Purpose To compare in a prospective noninferiority study optical coherence tomography (OCT) and intravascular ultrasound (IVUS) in popliteal and infrapopliteal vessels. Materials and Methods OCT and IVUS images of 112 popliteal and infrapopliteal arterial segments were prospectively obtained from 16 patients with peripheral arterial occlusive disease. Three observers evaluated the corresponding OCT and IVUS images for image quality, artifact frequency, discriminability of vessel wall layers, and plaque composition. Measurements of the lumen, vessel, and plaque areas were compared for both modalities. Results The intrareader and interreader reproducibility of plaque tissue discrimination (0.88 vs 0.75), overall image quality, and vessel wall layer discriminability were significantly higher for OCT (all P 0.9, P P Conclusions OCT imaging of infrapopliteal arteries is feasible and safe and provides high image quality. It enables an accurate assessment of vessel lumen, wall, and plaque. Compared with IVUS, OCT images provide excellent image quality and superior visualization of vessel wall layers and different plaque components. The penetration depth of OCT restricts its use to suitable vessel regions.