OCT guidance during stent implantation in primary PCI: A randomized multicenter study with nine months of optical coherence tomography follow-up
Jazyk angličtina Země Nizozemsko Médium print-electronic
Typ dokumentu srovnávací studie, časopisecké články, multicentrická studie, randomizované kontrolované studie
PubMed
29079414
DOI
10.1016/j.ijcard.2017.10.059
PII: S0167-5273(16)32175-1
Knihovny.cz E-zdroje
- Klíčová slova
- Drug-eluting stents, OCT, Optical coherence tomography, Primary PCI, ST-segment elevation myocardial infarction,
- MeSH
- časové faktory MeSH
- infarkt myokardu s elevacemi ST úseků diagnostické zobrazování chirurgie MeSH
- koronární angioplastika metody MeSH
- lidé středního věku MeSH
- lidé MeSH
- následné studie MeSH
- optická koherentní tomografie metody MeSH
- peroperační monitorování metody MeSH
- senioři MeSH
- stenty uvolňující léky * MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- randomizované kontrolované studie MeSH
- srovnávací studie MeSH
AIMS: To assess the possible merits of optical coherence tomography (OCT) guidance in primary percutaneous coronary intervention (pPCI). METHODS AND RESULTS: 201 patients with ST-elevation myocardial infarction (STEMI) were enrolled in this study. Patients were randomized either to pPCI alone (angio-guided group, n=96) or to pPCI with OCT guidance (OCT-guided group, n=105) and also either to biolimus A9 or to everolimus-eluting stent implantation. All patients were scheduled for nine months of follow-up angiography and OCT study. OCT guidance led to post-pPCI optimization in 29% of cases (59% malapposition and 41% dissections). No complications were found related to the OCT study. OCT analysis at nine months showed significantly less in-segment area of stenosis (6% [-11, 19] versus 18% [3, 33]; p=0.0002) in favor of the OCT-guided group. The rate major adverse cardiovascular events were comparable at nine months in both groups (3% in the OCT group versus 2% in the angio-guided group; p=0.87). CONCLUSIONS: This study demonstrates the safety of OCT guidance during pPCI. The use of OCT optimized stent deployment in 1/3 of patients in this clinical scenario and significantly reduced in-segment area of stenosis at nine months of follow-up. Whether such improvements in OCT endpoints will have a positive impact on late clinical outcomes, they demand both a larger and longer-term follow-up study.
Department of Biomedical Engineering Case Western Reserve University Cleveland OH USA
Department of Cardiology and Internal Medicine University Hospital Brno Brno Czech Republic
Harrington Heart and Vascular Institute University Hospitals Case Medical Center Cleveland USA
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