Usefulness of Frequency Domain Optical Coherence Tomography Compared with Intravascular Ultrasound as a Guidance for Percutaneous Coronary Intervention.

Authors
In-Cheol KimHyuck-Jun YoonEun-Seok ShinMin-Seok Kim Jincheol ParkYun-Kyeong ChoHyoung-Seob ParkHyungseop KimChang-Wook NamSeong-Wook HanYoon-Nyun KimKwon-Bae KimSeung-Ho Hur
Department
Dept. of Internal Medicine (내과학)
Issue Date
2016
Citation
Journal of Interventional Cardiology, Vol.29(2) : 216-224, 2016
ISSN
1540-8183
Abstract
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 2 for OCT, >5mm 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. 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
URI
http://kumel.medlib.dsmc.or.kr/handle/2015.oak/33381
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
Full Text
https://onlinelibrary.wiley.com/doi/abs/10.1111/joic.12276
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