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- Title
Usefulness of Frequency Domain Optical Coherence Tomography Compared with Intravascular Ultrasound as a Guidance for Percutaneous Coronary Intervention.
- Authors
Kim, In‐Cheol; Yoon, Hyuck‐Jun; Shin, Eun‐Seok; Kim, Min‐Seok; Park, Jincheol; Cho, Yun‐Kyeong; Park, Hyoung‐Seob; Kim, Hyungseop; Nam, Chang‐Wook; Han, Seong‐Wook; Kim, Yoon‐Nyun; Kim, Kwon‐Bae; Hur, Seung‐Ho
- Abstract
<bold>Objectives: </bold>To compare outcomes and rates of optimal stent placement between optical coherence tomography (OCT) and intravascular ultrasound (IVUS) guided percutaneous coronary intervention (PCI).<bold>Background: </bold>Unlike IVUS-guided PCI, rates of clinical outcomes and optimal stent placement have not been well characterized for OCT-guided PCI.<bold>Methods: </bold>The study enrolled 290 patients who underwent implantation of a second generation drug eluting stent under OCT (122 patients) or IVUS (168 patients) guidance. The two groups were compared after adjusting for baseline differences using 1:1 propensity score matching (PSM) (114 patients in each group). Optimal stent placement was defined as achieving an adequate lumen (optimal minimum stent area [MSA > 4.85 mm(2) for OCT, >5 mm(2) for IVUS] or a final MSA ≥ 90% of the distal reference lumen area, without edge dissection, incomplete stent apposition, or tissue prolapse), or otherwise performing additional interventions to address suboptimal post-stenting OCT or IVUS findings. The primary endpoint was one-year cumulative incidence of major adverse cardiac events (MACE; cardiac death, myocardial infarction and target lesion revascularization). Definite or probable stent thrombosis (ST) rates were evaluated.<bold>Results: </bold>In adjusted comparisons between OCT and IVUS groups, there was no significant difference in rates of MACE (3.5% vs. 3.5%, P = 1.000) and ST (0% vs. 0.9%, P = 1.000) at 1 year, optimal stent placement (89.5% vs. 92.1%, P = 0.492), and further intervention (7.9% vs.13.2%, P = 0.234), despite OCT significantly more frequently detecting tissue prolapse (97.4% vs. 47.4%, P < 0.001), and numerically more edge dissection (10.5% vs. 4.4%, P = 0.078) or incomplete stent apposition (48.2% vs. 36.8%, P = 0.082).<bold>Conclusions: </bold>OCT guidance showed comparable results to IVUS in mid-term clinical outcomes, suggesting that OCT can be an alternative tool for stent placement optimization.
- Subjects
SURGICAL stents; INTRAVASCULAR ultrasonography; PERCUTANEOUS coronary intervention; HEALTH outcome assessment; OPTICAL coherence tomography; CORONARY heart disease surgery; CARDIOVASCULAR system; COMPARATIVE studies; RESEARCH methodology; MEDICAL care; MEDICAL cooperation; PROBABILITY theory; RESEARCH; ULTRASONIC imaging; EVALUATION research; TREATMENT effectiveness; DISEASE incidence; RETROSPECTIVE studies; DRUG-eluting stents; CORONARY angiography
- Publication
Journal of Interventional Cardiology, 2016, Vol 29, Issue 2, p216
- ISSN
0896-4327
- Publication type
journal article
- DOI
10.1111/joic.12276