Frequency domain optical coherence tomography for guidance of coronary stenting

A coronary “tunnel”: Optical coherence tomography assessment after rotational atherectomy

“…In spite of high‐pressure postdilation, some malapposed struts were visualized. In this case, the use of OCT revealed a long dissection and guided our treatment and assessing the final result []. It is therefore a very illustrative case of the new possibilities available with OCT in the field of intravascular analysis.…”

Coronary optical coherence tomography: A practical overview of current clinical applications

“…44,45 Angiographic guidance for PCI in 335 patients was compared with angiographic plus OCT guidance in 335 patients in a propensity-score adjusted analysis (the CLI-OPCI study). 45 OCT disclosed adverse features, including stent malapposition, stent underexpansion, lumen narrowing, thrombus, or edge dissection, requiring further stenting or additional balloon dilatation in 34.7% of patients.…”

Percutaneous Coronary Intervention Planning and Optimization with Optical Coherence Tomography

“…However, several reports have shown the potential of OCT to support clinical decision making in PCI. [14][15][16][17][18] In pilot study of 90 patients undergoing PCI with OCT, OCT findings led to additional interventions in 32% (eg, additional balloon dilatation and stenting); the 6-month event-free survival rate was 98%. 14 Stefano and colleagues 15 reported a series of 150 consecutive patients in whom OCT was used for pre-PCI evaluation and/or stent optimization.…”

“…In a study of 108 patients undergoing OCT-guided coronary stenting, the procedure was deferred based on OCT findings in 19.1% of cases and resulted in further interventions in 34%. 16 Prati and colleagues 17 compared the 1-year clinical outcomes in 335 patients with OCT guidance with a matched control group undergoing PCI with angiographic guidance alone. The protocol provided several treatment recommendations based on OCT findings: (1) edge dissections (width >200 mm) with reference lumen narrowing (lumen area <4 mm 2 ) were treated with additional stenting; (2) stent underexpansion (in-stent MLA 90% of the average reference lumen area, or MLA 100% of the lowest lumen area of the reference segments) had further dilation with a noncompliant balloon of the same size at 18 atm or greater, or with a semicompliant balloon with a diameter 0.25 mm larger, at 14 atm or greater;…”