Optical coherence tomography—versus intravascular ultrasound-guided stent expansion in calcified lesions

Kurogi, Kazumasa; Ishii, Masanobu; Ikebe, Sou; Kaichi, Ryota; Mōri, Takayuki; Komaki, Soichi; Yamamoto, Nobuyasu; Yamanaga, Kenshi; Arima, Yuichiro; Yamamoto, Eiichiro; Kaikita, Koichi; Matsushita, Kenichi; Tsujita, Kenichi

doi:10.1007/s12928-021-00790-7

Cited by 15 publications

(11 citation statements)

References 21 publications

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“…To reduce the consumption of contrast medium, manual flushing with 7-15 mL of low-molecular-weight dextran (LMWD) can be used for repeated observations. Although renal toxicity of LMWD has been reported in systematic administration to stabilize blood pressure (13), the small amount used for flushing in the OCT observation does not have a significant effect on renal function due to total consumption of <100 mL (9,14). The image quality obtained after LMWD flushing is similar to that obtained after flushing with a contrast medium and is sufficient to reconstruct a 3D image (15) (Supplementary Movie 1).…”

Section: Methods Of D Oct Imagingmentioning

confidence: 65%

“…For clear visualization in OCT imaging, complete removal of red blood cells from the vessel by flushing is required. In the OCT-guided coronary bifurcation intervention, five or more observations are recommended, which include pullbacks from both the main vessel (MV) and SB in pre-intervention and at the final procedure, assessment of guidewire recrossing to the SB, and correction of stent failure or wiring failure (3,7,(9)(10)(11)(12). To reduce the consumption of contrast medium, manual flushing with 7-15 mL of low-molecular-weight dextran (LMWD) can be used for repeated observations.…”

Section: Methods Of D Oct Imagingmentioning

confidence: 99%

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How to use three-dimensional optical coherence tomography effectively in coronary bifurcation stenting

Murasato

2022

Front. Cardiovasc. Med.

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Imaging-guided coronary bifurcation intervention has improved clinical outcomes due to the appropriate size selection of the devices and optimization of the procedure (sufficient stent expansion, reduction of stent malapposition, appropriate stent landing zone, and detection of vessel dissection). In particular, three-dimensional optical coherence tomography (3D OCT) facilitates clear visualization of stent configuration and guidewire position, which promotes optimal guidewire crossing to the side branch. Successive side branch dilation leads to wide ostial dilation with less strut malapposition. However, the link connection of the stent located on the bifurcated carina has been found to be an impediment to sufficient opening of the side branch, resulting in incomplete strut apposition. In such cases, the aggressive proximal optimization technique improves the jailing strut pattern, and 3D OCT navigates the guidewire crossing to the optimal cell that is most likely to be expanded sufficiently, which is not always a distal cell. In two-stent deployment, 3D OCT facilitates optimal guidewire crossing, which leads to less metallic carina, clustering, and overlapping. The present review describes a method of clear visualization and assessment with 3D OCT and discusses the efficacy of 3D OCT in coronary bifurcation stenting in clinical practice.

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Section: Methods Of D Oct Imagingmentioning

confidence: 65%

Section: Methods Of D Oct Imagingmentioning

confidence: 99%

How to use three-dimensional optical coherence tomography effectively in coronary bifurcation stenting

Murasato

2022

Front. Cardiovasc. Med.

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“…In addition, whether lesion-guided use of IVUS versus OCT in specific sub-populations can improve outcomes represents a key area for future investigation. For instance, greater stent expansion and significant reduction in calcium thickness was reported with OCT-guided PCI in patients with calcified lesions [26] . It remains to be seen if these characteristics can be translated into differential clinical outcomes.…”

Section: Discussionmentioning

confidence: 99%

Trends and impact of intravascular ultrasound and optical coherence tomography on percutaneous coronary intervention for myocardial infarction

Park¹,

Vemmou²,

An³

et al. 2023

IJC Heart & Vasculature

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“…OCT, unlike IVUS, allows evaluation of the vessel behind the calcification (without shadowing), which is essential for the correct sizing of the vessel. However, OCT penetration may be a limitation in the imaging of deeply localized calcifications in a significantly remodeled vessel [ 25 ]. In turn, in ostial left-main lesion assessment and guidance, IVUS should be considered, as blood clearance needed for OCT may be challenging, if not impossible [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

Optical coherence tomography in the diagnosis of myocardial infarction with non-obstructive coronary arteries

Iwańczyk¹,

Woźniak²,

Araszkiewicz³

et al. 2022

pwki

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Myocardial infarction with non-obstructive coronary arteries (MINOCA) is a working diagnosis and requires identification of the underlying causes to optimize treatment, improve prognosis, and prevent the recurrence of myocardial infarction. According to the literature, the prognosis of patients diagnosed with MINOCA is comparable to the group of patients with myocardial infarction (MI) and significant stenosis of the coronary arteries. Intracoronary imaging is a crucial diagnostic tool used in identifying epicardial causes of MINOCA that are not visible in coronary angiography. Optical coherence tomography (OCT) provides the highest spatial resolution, simultaneously allowing detailed visualization of plaque pathology in individuals with MINOCA and identifying the cause of MI in up to 80% of patients. Common causes of a MINOCA may include plaque disruption, spontaneous coronary artery dissection (SCAD), coronary artery spasm, and coronary thromboembolism. The optimization of pharmacological treatment in this group of patients, especially dual antiplatelet therapy and statins, improves the prognosis. Data on the indications for invasive treatment of patients with MINOCA based on OCT findings are insufficient. There is a strong need for research comparing treatment strategies, especially in high-risk lesions visualized in OCT. The main aim of this review is to demonstrate the usefulness of OCT in determining the mechanism of MINOCA.

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Optical coherence tomography—versus intravascular ultrasound-guided stent expansion in calcified lesions

Cited by 15 publications

References 21 publications

How to use three-dimensional optical coherence tomography effectively in coronary bifurcation stenting

How to use three-dimensional optical coherence tomography effectively in coronary bifurcation stenting

Trends and impact of intravascular ultrasound and optical coherence tomography on percutaneous coronary intervention for myocardial infarction

Optical coherence tomography in the diagnosis of myocardial infarction with non-obstructive coronary arteries

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