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Optical Coherence Tomography

Abstract

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Current clinical applications of coronary optical coherence tomography Combining IVUS and Optical Coherence Tomography for More Accurate Coronary Cap Thickness Quantification and Stress/Strain Calculations: A Patient-Specific Three-Dimensional Fluid-Structure Interaction Modeling Approach Joint consensus on the use of OCT in coronary bifurcation lesions by the European and Japanese bifurcation clubs Early Strut Coverage in Patients Receiving Drug-Eluting Stents and its Implications for Dual Antiplatelet Therapy: A Randomized Trial Randomized comparison of stent strut coverage following angiography- or optical coherence tomography-guided percutaneous coronary intervention Characteristics of abnormal post-stent optical coherence tomography findings in hemodialysis patients Assessment and Quantitation of Stent Results by Intracoronary Optical Coherence Tomography Changes in Coronary Plaque Composition in Patients With Acute Myocardial Infarction Treated With High-Intensity Statin Therapy (IBIS-4): A Serial Optical Coherence Tomography Study
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Clinical Trial2018 Apr 6;13(18):e2174-e2181.

JOURNAL：EuroIntervention. Article Link

Characteristics of stent thrombosis in bifurcation lesions analysed by optical coherence tomography

Bechiri MY, Souteyrand G, Lefèvre T et al. Keywords: bifurcation; OCT; stent thrombosis; late ST; VLST; ACS/NSTE-ACS;

ABSTRACT

AIMS - This work aimed to investigate a cohort of patients presenting with stent thrombosis (ST) explored by optical coherence tomography (OCT) to identify the underlying mechanical abnormalities in case of bifurcation lesions.


METHODS AND RESULTS - The PESTO study was a prospective national registry involving 29 French catheterisation facilities. Patients with acute coronary syndromes were prospectively screened for presence of definite ST and analysed by OCT after culprit lesion reopening. The cohort involved 120 subjects, including 21 patients (17.5% of the global PESTO group; median age: 62.6 yrs; 76% male) with bifurcation lesions. The clinical presentation was acute or subacute ST in 34%, late ST in 5% and very late ST in 62% of the patients. The main underlying mechanisms were strut malapposition in 33%, stent underexpansion in 19% and isolated strut uncoverage in 19% of the cases. The proximal main branch was involved in 71%, distal main branch in 52% and jailed side branch in 5% of the patients.

CONCLUSIONS - In this cohort, bifurcation lesions represented a limited number of all ST cases. Different sections of the bifurcation could be involved. Although the underlying mechanisms were various, strut malapposition was the most frequently observed cause.
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