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Intravascular ultrasound-guided percutaneous coronary intervention improves the clinical outcome in patients undergoing multiple overlapping drug-eluting stents implantation Impact of coronary anatomy and stenting technique on long-term outcome after drug-eluting stent implantation for unprotected left main coronary artery disease Coronary Protection to Prevent Coronary Obstruction During TAVR: A Multicenter International Registry Apolipoprotein A-V is a potential target for treating coronary artery disease: evidence from genetic and metabolomic analyses Infective endocarditis after transcatheter aortic valve implantation: a nationwide study Long-term health outcome and mortality evaluation after invasive coronary treatment using drug eluting stents with or without the IVUS guidance. Randomized control trial. HOME DES IVUS Leaflet immobility and thrombosis in transcatheter aortic valve replacement Computed tomography angiography-derived extracellular volume fraction predicts early recovery of left ventricular systolic function after transcatheter aortic valve replacement Assessment and Quantitation of Stent Results by Intracoronary Optical Coherence Tomography Left Ventricular Rapid Pacing Via the Valve Delivery Guidewire in Transcatheter Aortic Valve Replacement
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Clinical Trial2013 Mar;6(3):228-36.

JOURNAL：JACC Cardiovasc Interv. Article Link

Optical coherence tomography versus intravascular ultrasound to evaluate coronary artery disease and percutaneous coronary intervention

Bezerra HG, Attizzani GF, Sirbu V et al. Keywords: IVUS; OCT; PCI

ABSTRACT

OBJECTIVES - We compared intravascular ultrasound (IVUS) and 2 different generations of optical coherence tomography (OCT)-time-domain OCT (TD-OCT) and frequency-domain OCT (FD-OCT)-for the assessment of coronary disease and percutaneous coronary intervention (PCI) using stents.


BACKGROUND - OCT is a promising light-based intravascular imaging modality with higher resolution than IVUS. However, the paucity of data on OCT image quantification has limited its application in clinical practice.

METHODS - A total of 227 matched OCT and IVUS pull backs were studied. One hundred FD-OCT and IVUS pull backs in nonstented (n = 56) and stented (n = 44) vessels were compared. Additionally, 127 matched TD-OCT and IVUS images were compared in stented vessels.

RESULTS - FD-OCT depicted more severe native coronary disease than IVUS; minimal lumen area (MLA) was 2.33 ± 1.56 mm(2) versus 3.32 ± 1.92 mm(2), respectively (p < 0.001). Reference vessel dimensions were equivalent between FD-OCT and IVUS in both native and stented coronaries, but TD-OCT detected smaller reference lumen size compared with IVUS. Immediately post-PCI, in-stent MLAs were similar between FD-OCT and IVUS, but at follow-up, both FD-OCT and TD-OCT detected smaller MLAs than did IVUS, likely due to better detection of neointimal hyperplasia (NIH). Post-PCI malapposition and tissue prolapse were more frequently identified by FD-OCT.

CONCLUSIONS - FD-OCT generates similar reference lumen dimensions but higher degrees of disease severity and NIH, as well as better detection of malapposition and tissue prolapse compared with IVUS. First-generation TD-OCT was associated with smaller reference vessel dimensions compared with IVUS.

Copyright © 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
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