Comparing Optical Coherence Tomography and Intravascular Ultrasound Guidance for Percutaneous Coronary Intervention: Trends and Outcomes 2010-2019

Balakrishna, Akshay Machanahalli; Ismayl, Mahmoud; Walters, Ryan W.; Aboeata, Ahmed; Gowda, Ramesh M.; Vallabhajosyula, Saraschandra; Goldsweig, Andrew M.; Dahal, Khagendra

doi:10.1016/j.cpcardiol.2022.101270

Cited by 9 publications

(5 citation statements)

References 16 publications

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“…As supported by Zein et al, the comprehensive procedural success rate exhibited an enhancement from 45% in 2010 to 55% in 2017 [41]. More recent data from the PROGRESS-CTO International Registry showed an increased success rate over time, from 81.6% in 2016 to 88.1% in 2021 (p < 0.0001) [42]. Fellowships and educational courses, like Complex, Higher-Risk, and Indicated Percutaneous Coronary Intervention (CHIP), could play a pivotal role in enhancing clinical knowledge and providing practical training, resulting in improved procedural outcomes [43].…”

Section: Discussionmentioning

confidence: 80%

Efficacy and Safety of Thirty-Day Dual-Antiplatelet Therapy Following Complex Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis

Apostolos,

Chlorogiannis,

Chrysostomidis

et al. 2024

JCDD

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The optimal duration of DAPT after complex PCI remains under investigation. The purpose of this systematic review and meta-analysis was to explore the safety and efficacy of a one-month therapy period versus a longer duration of DAPT after complex PCI. We systematically screened three major databases, searching for randomized controlled trials or sub-analyses of them, which compared shortened DAPT (S-DAPT), namely, one month, and longer DAPT (L-DAPT), namely, more than three months. The primary endpoint was any Net Adverse Clinical Event (NACE), and the secondary was any MACE (Major Adverse Cardiac Event), its components (mortality, myocardial infarction, stroke, and stent thrombosis), and major bleeding events. Three studies were included in the analysis, with a total of 6275 patients. Shortening DAPT to 30 days after complex PCI did not increase the risk of NACEs (OR: 0.77, 95% CI: 0.52–1.14), MACEs, mortality, myocardial infractions, stroke, or stent thrombosis. Pooled major bleeding incidence was reduced, but this finding was not statistically significant. This systematic review and meta-analysis showed that one-month DAPT did not differ compared to a longer duration of DAPT after complex PCI in terms of safety and efficacy endpoints. Further studies are still required to confirm these findings.

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Section: Discussionmentioning

confidence: 80%

Efficacy and Safety of Thirty-Day Dual-Antiplatelet Therapy Following Complex Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis

Apostolos,

Chlorogiannis,

Chrysostomidis

et al. 2024

JCDD

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“…The main findings of the presented study are that the frequency of OCT and IVUS use as auxiliary tools in the assessment of stenosis pathology and severity in CA as well as PCI treatment outcomes have recently significantly improved in Poland. However, the frequency of IVUS and OCT application during CA and/or PCI is still low compared to other countries, in which their prevalence and frequency of use are close to the optimal and actual needs [14]. Based on the data from the US National Readmission Database, between 2010 and 2019, it was reported, for instance, that the rate of OCT-guided PCI was almost 0.6% and IVUS--guided PCI nearly 10% of all procedures, which is much higher than in our cohort of patients although our analysis came from a later period [14].…”

Section: Discussionmentioning

confidence: 96%

“…However, the frequency of IVUS and OCT application during CA and/or PCI is still low compared to other countries, in which their prevalence and frequency of use are close to the optimal and actual needs [14]. Based on the data from the US National Readmission Database, between 2010 and 2019, it was reported, for instance, that the rate of OCT-guided PCI was almost 0.6% and IVUS--guided PCI nearly 10% of all procedures, which is much higher than in our cohort of patients although our analysis came from a later period [14]. Similarly, in another trial conducted in the US on a group of over 3 million patients, as early as 2016, a higher frequency of IVUS-and OCT-guided PCI was found compared to Poland; the IVUS-guided PCI amounted to 6.6% and OCT-guided PCI to 0.3% [15].…”

Section: Discussionmentioning

confidence: 96%

Factors determining the frequency of optical coherence tomography and intravascular ultrasound use in patients treated with percutaneous coronary interventions in recent years: Analysis based on a large national registry

Januszek,

Siudak,

Malinowski

et al. 2023

Kardiol Pol

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Background: Intravascular ultrasound (IVUS) and optical coherence tomography (OCT) have demonstrated improvement in the clinical outcome of patients undergoing percutaneous coronary intervention (PCI). Aims:We aimed to examine the frequency of implementing OCT and IVUS during coronary angiography (CA) and PCI in everyday practice in Poland. Factors related to the more common choice of these imaging techniques were determined. Methods: Data from the Polish National Registry of Percutaneous Coronary Interventions (ORPKI)were procured for analysis. Between January 2014 and December 2021, we extracted data on 1 452 135 CAs, 11 710 using IVUS (0.8%) and 1471 with OCT (0.1%) and 838 297 PCIs, 15 436 with IVUS (1.8%) and 1680 with OCT (0.2%). We assessed the determining factors for applying IVUS and OCT via multiple regression logistics models. Results:The frequency of applying IVUS during CAs and PCIs increased significantly between the years 2014 and 2021. In 2021, it reached 1.54% for CAs and 4.42% for PCIs, while for OCT, there was a rise regarding the CA group, namely 0.13% in 2021, and, in the PCI group, 0.43%. Age was one of the factors significantly associated with the frequency of using IVUS/OCT during CA/PCI, which was confirmed by multivariate analysis (Odds ratio: 0.981 for IVUS and 0.973 for OCT use with PCI). Conclusion:The frequency at which IVUS and OCT were used has undergone a significant increase in previous years. This increase can be largely attributed to the current reimbursement policies. Further improvement is required for this frequency to be at a satisfactory level.

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“…Optic coherence tomography (OCT) is a high‐resolution intravascular imaging technique that uses near‐infrared light, with a high spatial resolution (10–20 μm). 10 , 11 OCT has been widely used in coronary intervention procedures to see plaque morphology, stent apposition, and stent endothelialization. 11 , 12 In the present study, we hypothesized that endothelialization of LAAO could be evaluated by the high‐resolution OCT images and conducted a pilot study to address this issue.…”

mentioning

confidence: 99%

“… 10 , 11 OCT has been widely used in coronary intervention procedures to see plaque morphology, stent apposition, and stent endothelialization. 11 , 12 In the present study, we hypothesized that endothelialization of LAAO could be evaluated by the high‐resolution OCT images and conducted a pilot study to address this issue.…”

mentioning

confidence: 99%

Pattern of Endothelialization in Left Atrial Appendage Occluder by Optic Coherence Tomography: A Pilot Study

Chen,

Chiu,

Chang

et al. 2024

JAHA

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Background Implantation of the left atrial appendage occluder (LAAO) has been proven to prevent stroke effectively in patients with atrial fibrillation who cannot tolerate anticoagulants. Incomplete endothelization of LAAO may cause device‐related thrombus, and currently no good image modality exists to clearly see LAAO endothelialization. We aimed to use coronary optic coherence tomography (OCT) to visualize LAAO endothelialization. Methods and Results We enrolled 14 patients (72.8±9.4 years old) undergoing pulmonary vein isolation with a preexisting LAAO implanted more than 1 year ago (5 Watchman and 9 Amulet). After pulmonary vein isolation, we did OCT via steerable sheath and coronary guiding catheter to adjust OCT probe location and injected contrast medium to visualize the LAAO surface. In vitro testing was also performed to see the bare occluder. In vitro OCT showed the surface of the bare device as an interrupted granule pattern, which included the Watchman surface polytetrafluoroethylene membrane string, Amulet disc metal strut, and inner polytetrafluoroethylene membrane string. In the implanted Watchman, OCT showed endothelialization as a smooth surface layer with noninterrupted coarser granules. In the implanted Amulet, OCT showed endothelialization as thin (early) or thick (late) endothelialization layer covering struts with OCT shadows. Among patients with Watchman, 2 showed no, 2 early, and 1 complete endothelialization. Among patients with Amulet, 2 showed no, 3 early, and 4 late endothelialization. Conclusions We demonstrated the feasibility of OCT to visualize LAAO endothelization with high resolution. Further studies are needed to determine antithrombotic regimens if incomplete endothelization is detected. A new OCT catheter may be designed specifically for LAAO.

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Comparing Optical Coherence Tomography and Intravascular Ultrasound Guidance for Percutaneous Coronary Intervention: Trends and Outcomes 2010-2019

Cited by 9 publications

References 16 publications

Efficacy and Safety of Thirty-Day Dual-Antiplatelet Therapy Following Complex Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis

Efficacy and Safety of Thirty-Day Dual-Antiplatelet Therapy Following Complex Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis

Factors determining the frequency of optical coherence tomography and intravascular ultrasound use in patients treated with percutaneous coronary interventions in recent years: Analysis based on a large national registry

Pattern of Endothelialization in Left Atrial Appendage Occluder by Optic Coherence Tomography: A Pilot Study

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