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.
Links
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 193-201MeSH
AgedBlood 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 StudyJournal Article
Language
eng
PubMed ID
22456026
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