A multicentre evaluation of the safety of intracoronary optical coherence tomography

Barlis, Peter; Gonzalo, Nieves; Mario, Carlo Di; Prati, Francesco; Buellesfeld, Lutz; Rieber, Johannes; Dalby, Miles; Ferrante, Giuseppe; Cera, Maria; Grube, Eberhard; Serruys, Patrick W.; Regar, Evelyn

doi:10.4244/eijv5i1a14

Cited by 82 publications

(32 citation statements)

References 29 publications

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“…Optical coherence tomography (OCT) is an intracoronary imaging modality able to provide high-resolution (10 µm) images of the coronary artery [5][6][7][8]. Moreover, the technique has demonstrated its ability to distinguish atherosclerotic plaques with different composition [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Relation between plaque type and dissections at the edges after stent implantation: An optical coherence tomography study

Gonzalo

Serruys

Okamura

et al. 2011

International Journal of Cardiology

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Section: Introductionmentioning

confidence: 99%

Relation between plaque type and dissections at the edges after stent implantation: An optical coherence tomography study

Gonzalo

Serruys

Okamura

et al. 2011

International Journal of Cardiology

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“…Given the emergence of new anti-thrombotic treatments and improved lesion assessment with intravascular imaging techniques, such as optical coherence tomography (OCT) 12 , we reasoned that stenting may not be mandated in all patients. OCT is a high-resolution (10 µm) endocoronary imaging technique based on near-infrared light.…”

Section: Introductionmentioning

confidence: 99%

Invasive management without stents in selected acute coronary syndrome patients with a large thrombus burden: a prospective study of optical coherence tomography guided treatment decisions

Amabile¹,

Combaret²,

Hammas³

et al. 2015

EuroIntervention

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2 STRUCTURED ABSTRACT Aims:To assess whether a strategy of invasive management without stents in selected acute coronary syndrome (ACS) patients with a large thrombus burden (LTB) might be feasible and safe. Methods and results:We performed a prospective non-randomised observational cohort study of invasive treatment decisions guided by optical coherence tomography (OCT) in selected ACS patients with LTB.Among 852 ACS patients who had undergone invasive coronary angiography, 101(11.8%) patients with large thrombus burden on initial angiography underwent thrombectomy to restore TIMI-3 flow without stenting. All of these patients then had repeat angiography with OCT (Day 0-2 (Group1), Day 3-6 (Group2) or Day 7-30 (Group3)).No adverse events occurred between the initial and second angiograms. Residual thrombus was detected in 68% of patients with OCT (respectively, 94%, 79% and 32% in Group1, Group2 and Group3) and 20% of cases with angiography. Plaque rupture was detected by OCT in 65% of cases. Minimal lumen area was 2.81mm 2 , 3.40mm 2 and 4.89mm 2 in Group1, Group2 and Group3, respectively. 62% of patients were stented (respectively, 76%, 61% and 50%). During a minimum follow-up period of 12 months in all patients, 1 non-fatal MI occurred and 1 PCI was performed for angina. Conclusions:Medical management without stents is safe and feasible in selected ACS patients with LTB.OCT revealed culprit lesion characteristics that were not disclosed by angiography and facilitated treatment decisions. 3 KEY WORDSAcute coronary syndrome, optical coherence tomography, coronary thrombosis, myocardial infarction, percutaneous coronary intervention. 4 CONDENSED ABSTRACTWe assessed the feasibility and safety of invasive management and selected stenting or not, as guided by angiography and OCT, in ACS patients with LTB. In a 2-stage strategy, angiography was used to select patients for delayed stenting, and in the second procedure angiography and OCT were used to decide on stenting or not. OCT improved the assessment of culprit lesion characteristics and thrombus burden. Of 101 STEMI patients, 38% did not receive a stent. There were no adverse events related to OCT and only 2 non-fatal MACEs occurred during 12 months of follow-up. 5 ABBREVIATIONS LIST

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“…24 Manual or Power Injection Both manual and power injection of flushing media resulted in similar blood-free vessel lumen in the early TD-OCT studies. [25][26][27][28] In contrast, with current FD-OCT systems, power injections are more reliable in providing a blood-free lumen; this is because of a more consistent rate, duration, and volume of injection. 29 The safety, efficacy, and advantages of power injection for coronary angiography have been previously described.…”

Section: Flushing Options To Create a Blood-free Lumenmentioning

confidence: 99%

Technical Considerations and Practical Guidance for Intracoronary Optical Coherence Tomography

Katwal

López

2015

Interventional Cardiology Clinics

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A multicentre evaluation of the safety of intracoronary optical coherence tomography

Cited by 82 publications

References 29 publications

Relation between plaque type and dissections at the edges after stent implantation: An optical coherence tomography study

Relation between plaque type and dissections at the edges after stent implantation: An optical coherence tomography study

Invasive management without stents in selected acute coronary syndrome patients with a large thrombus burden: a prospective study of optical coherence tomography guided treatment decisions

Technical Considerations and Practical Guidance for Intracoronary Optical Coherence Tomography

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