Optical coherence tomography guidance for percutaneous coronary intervention with bioresorbable scaffolds
| Autor: | Caiazzo, G., Longo, G., Giavarini, A., Kılıç, İsmail Doğu, Fabris, E., Serdoz, R., Mattesini, A., Foin, N., Secco, G.G., De Rosa, S., Indolfi, C., Di Mario, C. |
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| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Male
diagnostic imaging retrospective study Coronary Artery Disease Article Percutaneous coronary intervention Blood Vessel Prosthesis Implantation stent fracture blood vessel prosthesis coronary artery bypass graft middle aged Absorbable Implants Humans controlled study balloon implantation human procedures optical coherence tomography blood vessel transplantation Tissue Scaffolds adult tissue scaffold bioresorbable scaffold frequency domain optical coherence tomography major clinical study Coronary Vessels aged Bioresorbable vascular scaffold female Treatment Outcome priority journal biodegradable implant Surgery Computer-Assisted computer assisted surgery coronary blood vessel balloon dilatation sense organs coronary angiography devices Tomography Optical Coherence |
| Popis: | Background The effect of optical coherence tomography (OCT) guidance on the implantation strategy during all phases of percutaneous coronary intervention (PCI) with bioresorbable vascular scaffolds (BVSs) in a real-world scenario has been poorly investigated. Methods Consecutive patients undergoing BVS implantation at our institution were included in this registry. Frequency-domain OCT pullbacks were performed at the operator's discretion during all phases of BVS implantation procedures to optimize preparation of lesions, confirm BVS size, and optimize expansion and apposition of scaffolds. Results Between September 2012 and July 2015, 203 BVSs were implanted in 101 consecutive patients at our institution (2.01 BVSs/patient). In 66 patients, the procedure was performed under OCT guidance. In the OCT subgroup, 66 (77.6%) of the 85 treated lesions were complex (B2/C AHA/ACC type). Overall, 147 OCT pullbacks were performed and 72/147 (49.0%) pullbacks indicated the need for changing strategy. After angiography-only-guided optimisation of BVS in 27 (31.8%) lesions, an OCT examination prompted performance of a second post-expansion. This resulted in an increase in the minimal scaffold area (5.5 to 6.3 mm2, p = 0.004) and a decrease in the incomplete scaffold apposition area (1.1 to 0.6 mm2, p = 0.082), with no new stent fractures. When the population was divided according to the time of BVS implantation, an initial learning adaptation became evident, with the number of OCT-guided changes in strategy significantly decreasing between the initial and final time periods (p = 0.017). Conclusions OCT guidance for BVS implantation significantly affects the procedural strategy, with favourable effects on acute results and the learning curve. © 2016 |
| Databáze: | OpenAIRE |
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