Intricacies in the analysis and interpretation of optical coherence tomography findings

Räber, Lorenz; Zaugg, Serge; Windecker, Stephan; Jüni, Peter

doi:10.4244/eijv9i12a232

Cited by 10 publications

(3 citation statements)

References 16 publications

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“…Not all papers reported the acquisition characteristics but 62% of the papers and conference abstracts used a rate of 1 cross‐section/mm. With the large number of studies and variation in methodological analysis, our paper is unfortunately unable to account for these differences .…”

Section: Discussionmentioning

confidence: 94%

Temporal Trends in Strut‐Level Optical Coherence Tomography Evaluation of Coronary Stent Coverage

Lee

Hsu

et al. 2015

Cathet Cardio Intervent

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Section: Discussionmentioning

confidence: 94%

Temporal Trends in Strut‐Level Optical Coherence Tomography Evaluation of Coronary Stent Coverage

Lee

Hsu

et al. 2015

Cathet Cardio Intervent

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“…Not all papers reported the acquisition characteristics but 62% of the papers and conference abstracts used a rate of 1 cross-section/mm. With the large number of studies and variation in methodological analysis, our paper is unfortunately unable to account for these differences [27].…”

Section: Study Limitationsmentioning

confidence: 93%

TCT-847 Strut Level Optical Coherence Tomography Evaluation of Coronary Stent Strut Coverage Temporal Trends: A Systematic Review

Lee

Riaz

et al. 2013

Journal of the American College of Cardiology

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Background: Recent randomized controlled trials (RCTs) have called into question whether percutaneous coronary intervention (PCI) reduces death or myocardial infarction in patients with stable ischemic heart disease (SIHD). However, several of these trials randomized an unselected group of patients, including those with and without objective ischemia. Methods: We performed a meta-analysis of RCTs comparing PCI with medical therapy (MT) in pts with either ischemia (identified on non-invasive testing) or abnormal fractional flow reserve (FFR), to determine whether PCI reduces all-cause mortality in this high-risk SIHD cohort. Results: Four RCTs comparing PCI vs. MT in pts with objective ischemia (or FFRequivalent) were found; these trials randomized a total of 1,769 pts with f/u from 7 months to 10 years. The point estimate of the hazard ratio (HR) for mortality following PCI vs. MT varied from 0.33-0.73, with no trial heterogeneity (I2¼0%). Of note, the documented ischemia cohort of the COURAGE trial (Am Heart J 2012) comprised 48% of the weight of the included studies. Overall, 28/871 (3.2%) PCI pts died compared with 54/898 MT pts (6.0%), consistent with a significant reduction in allcause mortality with PCI (HR 0.56; 95% confidence interval (CI): 0.34-0.93, p¼0.02, Figure), which remained significant when 3 other ineligible RCTs were added which included a PCI vs MT arm (HR 0.61 [0.42,0.89], p¼0.01).Conclusions: Despite conventional conclusions drawn from existing RCT data that PCI and MT result in comparable survival in SIHD, when analyses are restricted to pts with objective ischemia (or the FFR equivalent), PCI is associated with a significant and consistent 44% reduction in all-cause mortality compared with MT.

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“…Categorical data are presented as number (percentage). To account for the clustered nature of OCT-data, multilevel regression analyses on lesion level, cross-section level and strut level were realised [13,14,27]. For intra-group analysis within each group, an analysis of variance was performed.…”

Section: Discussionmentioning

confidence: 99%

Optical coherence tomography-guided versus angiography-guided implantation of everolimus-eluting bioresorbable vascular scaffolds: Comparison of coverage, apposition and clinical outcome. The ALSTER-OCT ABSORB registry

et al. 2018

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Background: Suboptimal implantation of everolimus-eluting bioresorbable vascular scaffolds (EE--BVS) leading to strut malapposition and lack of neointima coverage has been hypothesized to be linked to late BVS-thrombosis. Optical coherence tomography (OCT) allows assessing subtle differences in BVS--healing. We aimed to link 6-months OCT-data on EE-BVS coverage and malapposition to implantation technique and clinical outcome. Methods: Twenty-nine consecutive EE-BVS-patients were included. EE-BVS-implantation was guided by angiography in the first 17 patients (group 1). Vessel sizing prior to implantation and implantation result was assessed by OCT in the 12 following patients (group 2). EE-BVS-implantation was performed in both groups with adequate lesion preparation, sizing and systematic high-pressure post-dilatation. All patients received 6-months invasive control including OCT-analysis and clinical follow-up for 2 years.Results: The rate of uncovered struts was group 1: 10.8 ± 10.0%; group 2: 10.6 ± 8.2%, p = 0.934. Target lesion failure due to BVS-thrombosis occurred in 2/17 patients at 9 and 18 months (11.8%, group 1), and no patients in group 2 (p = 0.218). (Cardiol J 2018; 25, 4: 459-469) Conclusions: Optical coherence tomography analysis at 6-months following EE-BVS-implantation finds almost 90% of struts to be covered. No difference between OCT vs. angiography-guided EE-BVS--implantation was observed. OCT at 6-months was not able to predict late BVS-thrombosis of EE-BVS.

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Intricacies in the analysis and interpretation of optical coherence tomography findings

Cited by 10 publications

References 16 publications

Temporal Trends in Strut‐Level Optical Coherence Tomography Evaluation of Coronary Stent Coverage

Temporal Trends in Strut‐Level Optical Coherence Tomography Evaluation of Coronary Stent Coverage

TCT-847 Strut Level Optical Coherence Tomography Evaluation of Coronary Stent Strut Coverage Temporal Trends: A Systematic Review

Optical coherence tomography-guided versus angiography-guided implantation of everolimus-eluting bioresorbable vascular scaffolds: Comparison of coverage, apposition and clinical outcome. The ALSTER-OCT ABSORB registry

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