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Open AccessArticle

Real-Life Benefit of OCT Imaging for Optimizing PCI Indications, Strategy, and Results

1
Medical Clinic No. 1, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca 400006, Romania
2
Interventional Cardiology Department, Emergency Clinical Hospital, Cluj-Napoca 400006, Romania
*
Authors to whom correspondence should be addressed.
These authors contributed equally to this work.
J. Clin. Med. 2019, 8(4), 437; https://doi.org/10.3390/jcm8040437
Received: 29 January 2019 / Revised: 6 March 2019 / Accepted: 27 March 2019 / Published: 30 March 2019
Background: The aim of this study was to evaluate the benefit of standard practice Optical Coherence Tomography (OCT) imaging, as a complement to coronary angiography (CA), for optimizing the indications, strategy, and results of percutaneous coronary interventions (PCI). Methods: We retrospectively analyzed 182 patients with OCT imaging in a single tertiary center. Results: OCT use had a low prevalence (3.1% of 4256 CAs and 1.7% of 3027 PCIs). OCT was used post-CA in 71.5% and post-PCI in 28.5% of cases, mainly in acute coronary syndromes—95.6%. OCT was performed for borderline lesions in 43.4% of cases; lesion severity was reassessed as severe and led to PCI in 64.5% of them. OCT was performed for nonsignificant lesions in 17% of cases; lesion severity was reassessed as severe and led to PCI in 38.7% of them. OCT provided optimal selection for PCI strategy in 11% of cases. OCT identified suboptimal PCI results in 54% left main PCIs and in 48% bifurcation PCIs with optimal CA; PCI optimization was performed. In the only seven patients with suboptimal PCI, OCT revealed an optimal result in four cases, thus avoiding unneccessary optimization. In 27.3% of patients with post-CA OCT and PCI result “systematic” OCT control, a PCI optimization was indicated. Conclusion: OCT supplied a major benefit in 86.2% of cases, especially by identifying significant coroanry stenosis in CA borderline and nonsignificant lesions; OCT led to PCI indication in two-thirds and, respectively, one-third of these cases. In the post-PCI context, OCT led to an indication of PCI optimization in half of the complex left main and bifurcation lesions, as well as in a quarter of “systematic” post-PCI OCT controls. View Full-Text
Keywords: optical coherence tomography; percutaneous coronary interventions; borderline lesions; nonsignificant lesions; left main; bifurcations optical coherence tomography; percutaneous coronary interventions; borderline lesions; nonsignificant lesions; left main; bifurcations
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Olinic, D.M.; Spinu, M.; Homorodean, C.; Ober, M.C.; Olinic, M. Real-Life Benefit of OCT Imaging for Optimizing PCI Indications, Strategy, and Results. J. Clin. Med. 2019, 8, 437.

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