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https://hdl.handle.net/11499/9403
Title: | Optical coherence tomography guidance for percutaneous coronary intervention with bioresorbable scaffolds | Authors: | Caiazzo, G. Longo, G. Giavarini, A. Kılıç, İsmail Doğu Fabris, E. Serdoz, R. Mattesini, A. |
Keywords: | Bioresorbable vascular scaffold Optical coherence tomography Percutaneous coronary intervention adult Article balloon balloon dilatation bioresorbable scaffold controlled study coronary angiography coronary artery bypass graft coronary artery disease female frequency domain optical coherence tomography human implantation major clinical study male middle aged optical coherence tomography percutaneous coronary intervention priority journal retrospective study stent fracture aged biodegradable implant blood vessel prosthesis blood vessel transplantation computer assisted surgery coronary blood vessel devices diagnostic imaging procedures tissue scaffold treatment outcome Absorbable Implants Aged Blood Vessel Prosthesis Blood Vessel Prosthesis Implantation Coronary Artery Disease Coronary Vessels Female Humans Male Middle Aged Percutaneous Coronary Intervention Surgery, Computer-Assisted Tissue Scaffolds Tomography, Optical Coherence Treatment Outcome |
Publisher: | Elsevier Ireland Ltd | Abstract: | 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 | URI: | https://hdl.handle.net/11499/9403 https://doi.org/10.1016/j.ijcard.2016.07.033 |
ISSN: | 0167-5273 |
Appears in Collections: | PubMed İndeksli Yayınlar Koleksiyonu / PubMed Indexed Publications Collection Scopus İndeksli Yayınlar Koleksiyonu / Scopus Indexed Publications Collection Tıp Fakültesi Koleksiyonu WoS İndeksli Yayınlar Koleksiyonu / WoS Indexed Publications Collection |
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