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Impact of frequency-domain optical coherence tomography guidance for optimal coronary stent implantation in comparison with intravascular ultrasound guidance.

Abstract

BACKGROUND
Frequency-domain optical coherence tomography (FD-OCT) is a novel, high resolution intravascular imaging modality. Intravascular ultrasound (IVUS) is a widely used conventional imaging modality for achieving optimal stent deployment. The aim of this study was to evaluate the impact of FD-OCT guidance for coronary stent implantation compared with IVUS guidance.
METHODS AND RESULTS
A total of 70 patients with de novo coronary artery lesions and either unstable or stable angina pectoris were enrolled in this randomized study (optical coherence tomography [OCT] group: n=35, IVUS group: n=35). In the OCT group, stent implantation was performed under FD-OCT guidance alone and final stent expansion was evaluated by IVUS. In the IVUS group, conventional IVUS guidance was used and final stent apposition was evaluated by FD-OCT. There were no significant differences regarding the procedural, fluoroscopy time, and contrast volume. Although device and clinical success rates also were similar, the visibility of vessel border was significantly lower in the OCT group (P<0.05). Minimum and mean stent area and focal and diffuse stent expansion were smaller (6.1±2.2 mm versus 7.1±2.1 mm, 7.5±2.5 versus 8.7±2.4 mm, 64.7±13.7% versus 80.3±13.4%, 84.2±15.8% versus 98.8±16.5%, P<0.05, respectively), and the frequency of significant residual reference segment stenosis at the proximal edge was higher in the OCT group (P<0.05). Incomplete apposed struts in both groups were similar (P=0.34).
CONCLUSIONS
FD-OCT guidance for stent implantation was associated with smaller stent expansion and more frequent significant residual reference segment stenosis compared with conventional IVUS guidance.

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  • Publisher Full Text
  • Authors

    Habara M, Nasu K, Terashima M, Kaneda H, Yokota D, Ko E, Ito T, Kurita T, Tanaka N, Kimura M, Ito T, Kinoshita Y, Tsuchikane E, Asakura K, Asakura Y, Katoh O, Suzuki T

    Institution

    Department of Cardiovascular Medicine, Toyohashi Heart Center, Toyohashi, Japan.

    Source

    Circulation. Cardiovascular interventions 5:2 2012 Apr pg 193-201

    MeSH

    Aged
    Blood Vessel Prosthesis Implantation
    Coronary Artery Disease
    Coronary Restenosis
    Coronary Vessels
    Female
    Humans
    Male
    Middle Aged
    Postoperative Complications
    Retrospective Studies
    Stents
    Surgery, Computer-Assisted
    Tomography, Optical Coherence
    Treatment Outcome
    Ultrasonography, Interventional

    Pub Type(s)

    Comparative Study
    Journal Article

    Language

    eng

    PubMed ID

    22456026