Usefulness of Frequency Domain Optical Coherence Tomography Compared with Intravascular Ultrasound as a Guidance for Percutaneous Coronary Intervention.
- In-Cheol Kim; Hyuck-Jun Yoon; Eun-Seok Shin; Min-Seok Kim Jincheol Park; Yun-Kyeong Cho; Hyoung-Seob Park; Hyungseop Kim; Chang-Wook Nam; Seong-Wook Han; Yoon-Nyun Kim; Kwon-Bae Kim; Seung-Ho Hur
- Dept. of Internal Medicine (내과학)
- Issue Date
- Journal of Interventional Cardiology, Vol.29(2) : 216-224, 2016
- Objectives: To compare outcomes and rates of optimal stent placement between optical coherence tomography
(OCT) and intravascular ultrasound (IVUS) guided percutaneous coronary intervention (PCI).
Background: Unlike IVUS-guided PCI, rates of clinical outcomes and optimal stent placement have not been well
characterized for OCT-guided PCI.
Methods: 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
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.
Results: In adjusted comparisons between OCT and IVUS groups, there was no signiﬁcant difference in rates of
MACE (3.5% vs. 3.5%, P ¼ 1.000) and ST (0% vs. 0.9%, P ¼ 1.000) at 1 year, optimal stent placement (89.5% vs.
92.1%, P ¼ 0.492), and further intervention (7.9% vs.13.2%, P ¼ 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 ¼ 0.078) or incomplete stent apposition (48.2% vs. 36.8%, P ¼ 0.082).
Conclusions: OCT guidance showed comparable results to IVUS in mid-term clinical outcomes, suggesting that
OCT can be an alternative tool for stent placement optimization
- Appears in Collections:
- 1. Journal Papers (연구논문) > 1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
- Keimyung Author(s)
- 김인철; 윤혁준; 조윤경; 박형섭; 김형섭; 남창욱; 한성욱; 김윤년; 김권배; 허승호
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