Häner, Jonas D.; Duband, Benjamin; Ueki, Yasushi; Otsuka, Tatsuhiko; Combaret, Nicolas; Siontis, George C.M.; Bär, Sarah; Stortecky, Stefan; Motreff, Pascal; Losdat, Sylvain; Windecker, Stephan; Souteyrand, Géraud; Räber, Lorenz (2022). Impact of intracoronary optical coherence tomography in routine clinical practice: A contemporary cohort study. Cardiovascular revascularization medicine, 38, pp. 96-103. Elsevier 10.1016/j.carrev.2021.07.024
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BACKGROUND/PURPOSE
Guidelines recommend intracoronary optical coherence tomography (OCT) to assess stent failure and guide percutaneous coronary intervention (PCI) but OCT may be useful for other indications in routine clinical practice.
METHODS/MATERIALS
We conducted an international registry of OCT cases at two large tertiary care centers to assess clinical indications and the potential impact on decision making of OCT in clinical routine. Clinical indications, OCT findings, and their impact on interventional or medical treatment strategy were retrospectively assessed.
RESULTS
OCT was performed in 810 coronary angiography cases (1928 OCT-pullbacks). OCT was used for diagnostic purposes in 67% (N = 542) and OCT-guided percutaneous coronary intervention in 50% (N = 404, 136 cases with prior diagnostic indication). Most frequent indications for diagnostic OCT were culprit lesion identification in suspected ACS (29%) and stent failure assessment (28%). OCT findings in the diagnostic setting influenced patient management in 74%. OCT-guided PCIs concerned ACS patients in 45%. Among the 55% with chronic coronary syndrome, long lesions >28 mm (19%), left main PCI (16%), and bifurcation PCI with side-branch-stenting (5%) were the leading indications for PCI-guidance. Post-procedural OCT findings led to corrective measures in 52% (26% malapposition, 14% underexpansion, 6% edge dissection, 3% intrastent mass, 3% geographic plaque miss).
CONCLUSIONS
OCT was most frequently performed to identify culprit lesions in suspected ACS, for stent failure assessment, and PCI-guidance. OCT may impact subsequent treatment strategies in two out of three patients.
Item Type: |
Journal Article (Original Article) |
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Division/Institute: |
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology 04 Faculty of Medicine > Pre-clinic Human Medicine > Department of Clinical Research (DCR) |
UniBE Contributor: |
Häner, Jonas, Ueki, Yasushi, Otsuka, Tatsuhiko, Siontis, Georgios, Bär, Sarah, Stortecky, Stefan, Losdat, Sylvain Pierre, Windecker, Stephan, Räber, Lorenz |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
1553-8389 |
Publisher: |
Elsevier |
Language: |
English |
Submitter: |
Andrea Flükiger-Flückiger |
Date Deposited: |
12 Aug 2021 17:31 |
Last Modified: |
20 Feb 2024 14:16 |
Publisher DOI: |
10.1016/j.carrev.2021.07.024 |
PubMed ID: |
34340915 |
Uncontrolled Keywords: |
Acute coronary syndrome Coronary artery disease OCT-guided PCI Optical coherence tomography Stent failure assessment |
BORIS DOI: |
10.48350/158010 |
URI: |
https://boris.unibe.ch/id/eprint/158010 |
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