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Is intravascular ultrasound beneficial for percutaneous coronary intervention of bifurcation lesions? Evidence from a 4,314-patient registry Predictors of high residual gradient after transcatheter aortic valve replacement in bicuspid aortic valve stenosis Prior Balloon Valvuloplasty Versus Direct Transcatheter Aortic Valve Replacement: Results From the DIRECTAVI Trial Meta-Analysis of Effectiveness and Safety of Transcatheter Aortic Valve Implantation Versus Surgical Aortic Valve Replacement in Low-to-Intermediate Surgical Risk Cohort Intravascular Ultrasound Guidance Is Associated With Better Outcome in Patients Undergoing Unprotected Left Main Coronary Artery Stenting Compared With Angiography Guidance Alone Six-month versus 12-month dual antiplatelet therapy after implantation of drug-eluting stents: the Efficacy of Xience/Promus Versus Cypher to Reduce Late Loss After Stenting (EXCELLENT) randomized, multicenter study Predictors and Clinical Outcomes of Next-Day Discharge After Minimalist Transfemoral Transcatheter Aortic Valve Replacement Prevalence and Outcomes of Concomitant Aortic Stenosis and Cardiac Amyloidosis Long-term effects of intensive glucose lowering on cardiovascular outcomes The Evolution of β-Blockers in Coronary Artery Disease and Heart Failure (Part 1/5)

LetterVolume 69, Issue 3, May 2017, Pages 407-410

JOURNAL:Indian Heart J. Article Link

Optical coherence tomography is a kid on the block: I would choose intravascular ultrasound

Dash D. Keywords: Percutaneous coronary intervention; Intravscular ultrasound; Optical coherence tomography; Vulnerable plaque; Biodegradable vascular scaffold

ABSTRACT

Intravascular imaging has improved our understanding of in vivo pathophysiology of coronary artery disease (CAD) and predicted decision-making in percutaneous coronary intervention (PCI). Intravascular ultrasound (IVUS) has emerged as the first clinical imaging method contributing significantly to modern PCI techniques. This modality has outlived many other intravascular techniques 26 years after its inception. It has assisted us in understanding dynamics of atherosclerosis and provides several unique insights into plaque burden, remodeling, and restenosis. It is useful as an imaging endpoint in large progression-regression trial and as workhorse in many catheterization laboratories. IVUS guidance appears to be most beneficial in complex lesion subsets that are being treated with drug-eluting stents. The recent introduction of optical coherence tomography (OCT), a light based imaging technique, has further expanded this field because of its higher resolution and faster image acquisition. The omnipresence of OCT raises the question: Does IVUS have a role in the era of OCT? Whether OCT is superior to IVUS in routine clinical practice? Even if OCT is currently gaining clinical significance in detailed planning of interventional strategies and stent optimization in complex lesion subsets, it is the much younger technique and has to prove its worth. Nevertheless, undoubtedly IVUS plays significant role in studies on coronary atherosclerosis and for guidance of PCI. In fact, both the methods are complementary rather than competitive.