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Catheter Cardiovasc Interv. 2013 Sep 1;82(3):E173-83. doi: 10.1002/ccd.24843. Epub 2013 Mar 16.

Frequency-domain optical coherence tomography assessment of unprotected left main coronary artery disease-a comparison with intravascular ultrasound.

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  • 1Harrington Heart and Vascular Institute, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio; Department of Cardiology, New Tokyo Hospital, Chiba, Japan.

Abstract

OBJECTIVES:

To investigate safety and feasibility of imaging unprotected left main (ULM) using frequency-domain optical coherence tomography (FD-OCT) compared with intravascular ultrasound (IVUS).

BACKGROUND:

IVUS has been used to assess and guide percutaneous coronary intervention (PCI) of ULM disease. FD-OCT offers 10-fold higher axial resolution than IVUS and its high-speed image acquisition obviates the need for proximal balloon occlusion.

METHODS:

We prospectively enrolled 35 consecutive patients with ULM disease. FD-OCT and IVUS assessments were attempted pre- and post-PCI and compared in regards to safety, ability to image the region of interest (ROI), number of pullbacks, volume of contrast and ability to detect malapposition, dissection, and thrombus.

RESULTS:

Patients were followed for 1 year when FD-OCT imaging was repeated. FD-OCT required more repeated pullbacks to image the ROI compared to IVUS. Mean lumen and stent areas were similar between FD-OCT and IVUS (11.24 ± 2.66 vs. 10.85 ± 2.47 mm(2) , P = 0.13 and 10.44 ± 2.33 vs. 10.49 ± 2.32 mm(2) , P = 0.82, respectively), whereas imaged stent length was shorter with FD-OCT. Malapposition areas and volumes were larger and more edge dissections were detected by FD-OCT. There were no clinical adverse events and no complications associated with FD-OCT at baseline and 1-year follow-up. All dissections were healed, whereas stent malapposition was still detected at follow-up.

CONCLUSIONS:

FD-OCT assessment of ULM is feasible and safe. Direct comparisons with IVUS reveal that FD-OCT achieved imaging completeness less often, whereas it was more sensitive in detecting malapposition and edge dissections, and similar to IVUS in the assessment of lumen and stent dimensions.

KEYWORDS:

intravascular ultrasound; left main coronary artery disease; optical coherence tomography; percutaneous coronary intervention

PMID:
23359350
DOI:
10.1002/ccd.24843
[PubMed - indexed for MEDLINE]
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