Joint consensus on the use of OCT in coronary bifurcation lesions by the European and Japanese bifurcation clubs

Onuma, Yoshinobu; Katagiri, Yuki; Burzotta, Francesco; Holm, Niels Ramsing; Amabile, Nicolas; Okamura, Takayuki; Mintz, Gary S.; Darremont, Olivier; Lassen, Jens Flensted; Lefèvre, Thierry; Louvard, Yves; Stanković, Goran; Serruys, Patrick W.

doi:10.4244/eij-d-18-00391

Cited by 58 publications

(60 citation statements)

References 114 publications

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“…Despite a very good angiographic result in these patients, OCT found suboptimal results in 48% of the cases, with need for optimization. These findings support the limited existing data [19,20,21] regarding the need for more than angiography in bifurcation PCI. Other clinical practitioners reported a 53.5% use of IVI for guiding bifurcation PCI [11].…”

Section: Discussionsupporting

confidence: 90%

Real-Life Benefit of OCT Imaging for Optimizing PCI Indications, Strategy, and Results

Olinic

Spînu

Homorodean

et al. 2019

JCM

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Background: The aim of this study was to evaluate the benefit of standard practice Optical Coherence Tomography (OCT) imaging, as a complement to coronary angiography (CA), for optimizing the indications, strategy, and results of percutaneous coronary interventions (PCI). Methods: We retrospectively analyzed 182 patients with OCT imaging in a single tertiary center. Results: OCT use had a low prevalence (3.1% of 4256 CAs and 1.7% of 3027 PCIs). OCT was used post-CA in 71.5% and post-PCI in 28.5% of cases, mainly in acute coronary syndromes—95.6%. OCT was performed for borderline lesions in 43.4% of cases; lesion severity was reassessed as severe and led to PCI in 64.5% of them. OCT was performed for nonsignificant lesions in 17% of cases; lesion severity was reassessed as severe and led to PCI in 38.7% of them. OCT provided optimal selection for PCI strategy in 11% of cases. OCT identified suboptimal PCI results in 54% left main PCIs and in 48% bifurcation PCIs with optimal CA; PCI optimization was performed. In the only seven patients with suboptimal PCI, OCT revealed an optimal result in four cases, thus avoiding unneccessary optimization. In 27.3% of patients with post-CA OCT and PCI result “systematic” OCT control, a PCI optimization was indicated. Conclusion: OCT supplied a major benefit in 86.2% of cases, especially by identifying significant coroanry stenosis in CA borderline and nonsignificant lesions; OCT led to PCI indication in two-thirds and, respectively, one-third of these cases. In the post-PCI context, OCT led to an indication of PCI optimization in half of the complex left main and bifurcation lesions, as well as in a quarter of “systematic” post-PCI OCT controls.

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Section: Discussionsupporting

confidence: 90%

Real-Life Benefit of OCT Imaging for Optimizing PCI Indications, Strategy, and Results

Olinic

Spînu

Homorodean

et al. 2019

JCM

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“…Operators can select those functions according to circumstances during the procedure. For instance, in a case of left main coronary artery disease, the operator can use the IVUS function for the purpose of assessing the severity and guide treatment ( 25 ), whereas OCT can be utilized to assess the final results and detect and treat underexpansion/malapposition and/or carina shift in the bifurcation ( 57 , 89 , 90 ). The cost is expected to be similar to that of OFDI.…”

Section: Recent Advances Of Ivus and Oct And Development Of The Hybrmentioning

confidence: 99%

Advances in IVUS/OCT and Future Clinical Perspective of Novel Hybrid Catheter System in Coronary Imaging

Ono

Kawashima

Hara

et al. 2020

Front. Cardiovasc. Med.

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Intravascular ultrasound (IVUS) and optical coherence tomography (OCT) have been developed and improved as both diagnostic and guidance tools for interventional procedures over the past three decades. IVUS has a resolution of 100 µm with a high tissue penetration and capability of assessing the entire structure of a coronary artery including the external elastic membrane, whereas OCT has a higher resolution of 10-20 µm to assess endoluminal structures with a limited tissue penetration compared to IVUS. Recently, two companies, CONAVI and TERUMO, integrated IVUS and OCT into a single catheter system. With their inherent strength and limitations, the combined IVUS and OCT probes are complementary and work synergistically to enable a comprehensive depiction of coronary artery. In this review, we summarize the performance of the two intracoronary imaging modalities-IVUS and OCT-and discuss the expected potential of the novel hybrid IVUS-OCT catheter system in the clinical field.

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“…Initiated in 2004, the European Bifurcation Club (EBC) has focused on improving bifurcation PCI practice by organizing annual meetings and promoting general consensus statements 1‐9 and consensus documents dedicated to specific bifurcation‐related topics 10‐17 . One of the most important concept arose from EBC events was the recognition that the final confirmation of stent struts into a bifurcated coronary lesion is strongly influenced by different factors including stent characteristics, 18 technique selection and procedural steps.…”

Section: Introductionmentioning

confidence: 99%

European Bifurcation Club white paper on stenting techniques for patients with bifurcated coronary artery lesions

Burzotta

Lassen

Louvard

et al. 2020

Cathet Cardio Intervent

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Background Defining the optimal conduction of percutaneous‐coronary‐intervention (PCI) to treat bifurcation lesions has been the subject of many clinical studies showing that the applied stenting technique may influence clinical outcome. Accordingly, bifurcation stenting classifications and technical sequences should be standardized to allow proper reporting and comparison. Methods The European Bifurcation Club (EBC) is a multidisciplinary group dedicated to optimize the treatment of bifurcations and previously created a classification of bifurcation stenting techniques that is based on the first stent implantation site. Since some techniques have been abandoned, others have been refined and dedicated devices became available, EBC promoted an international task force aimed at updating the classification of bifurcation stenting techniques as well as at highlighting the best practices for most popular techniques. Original descriptive images obtained by drawings, bench tests and micro‐computed‐tomographic reconstructions have been created in order to serve as tutorials in both procedure reporting and clinical practice. Results An updated Main‐Across‐Distal‐Side (MADS)‐2, classification of bifurcation stenting techniques has been realized and is reported in the present article allowing standardized procedure reporting in both clinical practice and scientific studies. The EBC‐promoted task force deeply discussed, agreed on and described (using original drawings and bench tests) the optimal steps for the following major bifurcation stenting techniques: (a) 1‐stent techniques (“provisional” and “inverted provisional”) and (b) 2‐stent techniques (“T/TAP,” “culotte,” and “DK‐crush”). Conclusions The present EBC‐promoted paper is intended to facilitate technique selection, reporting and performance for PCI on bifurcated lesions during daily clinical practice.

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Joint consensus on the use of OCT in coronary bifurcation lesions by the European and Japanese bifurcation clubs

Cited by 58 publications

References 114 publications

Real-Life Benefit of OCT Imaging for Optimizing PCI Indications, Strategy, and Results

Real-Life Benefit of OCT Imaging for Optimizing PCI Indications, Strategy, and Results

Advances in IVUS/OCT and Future Clinical Perspective of Novel Hybrid Catheter System in Coronary Imaging

European Bifurcation Club white paper on stenting techniques for patients with bifurcated coronary artery lesions

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