Current Use of Intracoronary Imaging in Interventional Practice　― Results of a European Association of Percutaneous Cardiovascular Interventions (EAPCI) and Japanese Association of Cardiovascular Interventions and Therapeutics (CVIT) Clinical Practice Survey ―

Koskinas, Konstantinos C.; Nakamura, Masato; Räber, Lorenz; Colleran, Róisín; Kadota, Kazushige; Capodanno, Davide; Wijns, William; Akasaka, Takashi; Valgimigli, Marco; Guagliumi, Giulio; Windecker, Stephan; Byrne, Robert A.

doi:10.1253/circj.cj-17-1144

Cited by 42 publications

(33 citation statements)

References 6 publications

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“…What's more, with the development of technology, some technique such as IVUS, OCT and kissing balloon may improve prognosis. The kissing balloon can reduce the risk of overall target lesion revascularization while the IVUS and OCT can be used to optimize stenting and guide procedural strategy (34,35). PCI may also be preferred because of its improved early safety profile.…”

Section: Discussionmentioning

confidence: 99%

Second drug-eluting stent implantation versus coronary artery bypass grafting in treatment of young patients with left main and/or multivessel coronary disease

Chen

Zhang

Yan

et al. 2019

Preprint

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Background Many studies have compared outcomes of coronary artery bypass graft (CABG) and percutaneous coronary intervention (PCI) for complex coronary artery disease (CAD). However, no trials have focused on young patients (< 45 years) with complex CAD. We conducted a retrospective evaluation to compare the outcomes of a 2nd drug-eluting stent and CABG in young patients with LM or three-vessel disease. Methods In the young patients with complex CAD who underwent PCI or CABG, Kaplan-Meier analysis and Cox regression before and after propensity-score matching were used to compare major adverse cardiac and cerebrovascular events (MACCE), including myocardial infarction (MI), stoke, death and repeat revascularization. Results During the follow-up, MACCE occurred in 20.5% of patients in the PCI group and 8.6% in the CABG group (hazard ratio [HR]: 3.263, 95% confidence interval [CI]: 1.379 to 7.722, p=0.007). Repeat revascularization occurred more frequently in the PCI group (18.9% vs. 3.7% respectively, HR: 6.968, 95% CI: 2.036 to 23.842, p=0.002). There were no significant differences in other endpoints. After propensity-score matching, no conclusions were changed. Conclusions In young patients with LM or three-vessel disease, PCI showed a higher incidence of MACCE, which was mainly driven by repeat revascularization. However that did not translate into hard endpoints differences. Therefore, PCI is an alternative treatment to CABG in young patients with complex CAD.

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Section: Discussionmentioning

confidence: 99%

Second drug-eluting stent implantation versus coronary artery bypass grafting in treatment of young patients with left main and/or multivessel coronary disease

Chen

Zhang

Yan

et al. 2019

Preprint

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“…IVUS or OCT should be considered for stent optimization, according to recent guidelines and consensus documents [ 5 , 13 , 41 , 42 ]. Most studies included in this review used stent optimization criteria derived from the MUSIC study by De Jaegere et al [ 43 ].…”

Section: Stent Optimization Criteriamentioning

confidence: 99%

“…In a web-based survey among 1105 interventional cardiologists, stent optimization (88.5%), preprocedural strategy guidance (79.6%), and left-main interventions (77.0%) were the main indications for ICI. High costs (65.9%) and prolongation of the procedure (35.0%) were mentioned as the main factors limiting the use of ICI [ 13 ].…”

Section: Indicationsmentioning

confidence: 99%

“…A recent consensus document by the European Association of Percutaneous Cardiovascular Interventions (EAPCI) appraised current evidence on clinical indications for ICI [ 42 ]. Pre-PCI strategy guidance and stent optimization are the main clinical applications of both OCT and IVUS [ 5 , 13 ]. Patients with ACS and complex lesions, including left-main, bifurcation, chronic total occlusion (CTO) and long lesions, benefit the most from ICI regarding all-cause mortality and MACE [ 12 , 50 ].…”

Section: Indicationsmentioning

confidence: 99%

“…However, the benefits of OCT in relation to IVUS are not always clear. Despite growing evidence, the adoption of ICI in clinical practice remains limited [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

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Optical Coherence Tomography: Current Applications for the Assessment of Coronary Artery Disease and Guidance of Percutaneous Coronary Interventions

et al. 2020

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Introduction Coronary angiography (CAG) is the standard modality for assessment of coronary stenoses and intraprocedural guidance of percutaneous coronary interventions (PCI). However, the limitations of CAG are well recognized. Intracoronary imaging (ICI) can potentially overcome these limitations. Intravascular ultrasound (IVUS) and optical coherence tomography (OCT) are the main ICI techniques utilized in clinical practice. Aim This narrative literature review addresses the current clinical applications of OCT in relation to IVUS and CAG in patients with coronary artery disease (CAD). Items reviewed are: technical implications of OCT and IVUS, lesion characterization and decision-making, stent optimization criteria, post-stenting results, safety in terms of procedural complications, clinical outcomes, and indications. Main Findings OCT is able to reveal more detail than IVUS due to its higher resolution. However, this higher resolution comes at the cost of a lower penetration depth. Pre-stenting OCT results in procedural change in more than 50% of the cases in terms of stent length and diameter. Post-stenting OCT resulting in stent optimization is reported in at least 27% of the cases. Malapposition and under-expansion are treated with post-dilatations, while edge dissections are treated with additional stent placement. Stent expansion, stent apposition, distal stent edge dissections, and reference lumen areas seem to be the most important stent optimization criteria for both decision-making and for reducing the risk of adverse events during follow-up. Both OCT and IVUS are superior in terms of post-stenting results compared with CAG alone. However, there is no consensus about whether OCT guidance results in better stent expansion than IVUS guidance. OCT, IVUS, and CAG are safe procedures with few reported procedural complications. In general, OCT guidance seems to contribute to favorable clinical outcomes compared with CAG guidance only. However, OCT guidance results in similar clinical outcomes as with IVUS guidance. OCT could be considered for lumen assessment and stent-related morphology in more complex cases in which CAG interpretation remains uncertain. Since OCT and IVUS have distinct characteristics, these techniques are complementary and should be considered carefully for each patient case based on the benefits and limitations of both techniques. Electronic supplementary material The online version of this article (10.1007/s40119-020-00185-4) contains supplementary material, which is available to authorized users.

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Evaluation of the thickness of coronary calcium by 60-MHz intravascular ultrasound: head-to-head comparison with optical frequency domain imaging

Oshikiri,

Ishida,

Sakamoto

et al. 2023

Int J Cardiovasc Imaging

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The region behind the coronary calcium could not be visualized by intravascular ultrasound (IVUS) because of acoustic shadow. However, some pathological studies have shown that IVUS delineated the vessel border behind thin coronary calcium sheets. This study aimed to reveal whether recent IVUS can visualize the region behind thin coronary calcium sheets. MethodsUsing 534 cross-sectional optical frequency domain images (OFDI), including severe calci ed coronary lesions, calcium sheet thickness was measured by every 1°. Accordingly, the visibility of the vessel border behind the coronary calcium sheet was evaluated using 60-MHz IVUS images, which were longitudinally linked with OFDI ones. After carefully coordinating with the axial position, the association between the IVUS-derived permeability of the coronary calcium sheet and calcium thickness was evaluated. ResultsThe maximum and mean calcium thickness by OFDI was 0.88 ± 0.39 and 0.62 ± 0.30 mm, respectively. By 60-MHz IVUS, 12.1% of the coronary calcium sheets had permeable segments. Comparing between OFDI and IVUS images, 48.6% of the coronary calcium sheets with maximum thickness ≤ 0.3 mm were sometimes permeable by 60-MHz IVUS, whereas most > 0.5-mm thick calcium sheets were impermeable.In the receiver operating characteristic curve analysis, the best cutoff values for the maximum and mean thickness of permeable calcium were 0.48 and 0.31 mm, respectively. ConclusionThus, 60-MHz IVUS can occasionally visualize the region behind a thin coronary calcium sheet. When using 60-MHz IVUS, this nding may be a predictive marker of calcium sheet with a thickness of < 0.5 mm.

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Current Use of Intracoronary Imaging in Interventional Practice　― Results of a European Association of Percutaneous Cardiovascular Interventions (EAPCI) and Japanese Association of Cardiovascular Interventions and Therapeutics (CVIT) Clinical Practice Survey ―

Cited by 42 publications

References 6 publications

Second drug-eluting stent implantation versus coronary artery bypass grafting in treatment of young patients with left main and/or multivessel coronary disease

Second drug-eluting stent implantation versus coronary artery bypass grafting in treatment of young patients with left main and/or multivessel coronary disease

Optical Coherence Tomography: Current Applications for the Assessment of Coronary Artery Disease and Guidance of Percutaneous Coronary Interventions

Evaluation of the thickness of coronary calcium by 60-MHz intravascular ultrasound: head-to-head comparison with optical frequency domain imaging

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Current Use of Intracoronary Imaging in Interventional Practice ― Results of a European Association of Percutaneous Cardiovascular Interventions (EAPCI) and Japanese Association of Cardiovascular Interventions and Therapeutics (CVIT) Clinical Practice Survey ―

Cited by 42 publications

References 6 publications

Second drug-eluting stent implantation versus coronary artery bypass grafting in treatment of young patients with left main and/or multivessel coronary disease

Second drug-eluting stent implantation versus coronary artery bypass grafting in treatment of young patients with left main and/or multivessel coronary disease

Optical Coherence Tomography: Current Applications for the Assessment of Coronary Artery Disease and Guidance of Percutaneous Coronary Interventions

Evaluation of the thickness of coronary calcium by 60-MHz intravascular ultrasound: head-to-head comparison with optical frequency domain imaging

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Current Use of Intracoronary Imaging in Interventional Practice　― Results of a European Association of Percutaneous Cardiovascular Interventions (EAPCI) and Japanese Association of Cardiovascular Interventions and Therapeutics (CVIT) Clinical Practice Survey ―