Abstract 11889: Safety and Usefulness of Frequency Domain Optical Coherence Tomography During Coronary Stent Implantation: A Comparison with Intravascular Ultrasound
Background: Intracoronary optical coherence tomography (OCT) is a high-resolution imaging modality that is recently used as invasive coronary imaging. Newly developed frequency domain OCT (FD-OCT) does not require time-consuming coronary occlusion by balloon catheter, and has much shorter image acquisition time than conventional time domain OCT (TD-OCT). We investigated the safety and usefulness of FD-OCT in imaging coronary stent during percutaneous coronary interventions (PCI) in comparison with intravascular ultrasound (IVUS).
Methods: Seventeen patients with coronary artery disease (62.5±10.9 y/o) were enrolled in this study, and 9 bare metal stent (BMS) and 14 drug elution stent (DES) were imaged by both FD-OCT (C7 system, Light Lab imaging) and IVUS just after stent implantation. Lumen area (LA) was measured at proximal and distal edges of stent, and at minimal lumen area within stented segment. Incidence of in-stent tissue prolapse (ISTP), incomplete stent apposition (ISA), thrombus formation (TF) and stent-edge dissection (SED) were evaluated by both modalities, and any adverse events and angiographic adverse findings were recorded. Scheduled follow-up angiography was performed (7.2±1.4 months).
Results: No patients experienced major complications by both procedures. LA values were tented to be larger in FD-OCT measurement compared with IVUS measurement, but did not reach statistical significance (proximal edge; 8.2± 2.8 vs. 7.4± 2.6mm2, p=0.34, distal edge; 6.6± 1.2 vs. 6.0± 1.1mm2 p=0.23, and 5.3±1.3 vs. 5.2± 1.1mm2 p=0.85). ISTP, ISA, TF, and SED were more frequently observed in FD-OCT observation than IVUS observation (100 vs. 17.3%; p<0.0001, 65.2 vs. 8.6%; p<0.0001, 17.4 vs. 0%, p=0.03, 40 vs. 0%, p=0.0019, respectively). Appearance of ISTP, ISA, TF and SED did not correlated with the development of angiographic restenosis at scheduled follow-up study.
Conclusions: This study showed that use of FD-OCT is safe and feasible during PCI. FD-OCT is more sensitive to detect inappropriate deployment of coronary stent compared to IVUS, but peri-procedural FD-OCT findings on stented segment did not correlated with angiographic restenosis in chronic phase.
- © 2011 by American Heart Association, Inc.