Objectives The authors sought to clarify how intravascular ultrasound (IVUS) and optical coherence tomography affect percutaneous coronary intervention (PCI) with current-generation drug-eluting stents in a pre-specified substudy of the OPINION (OPtical frequency domain imaging versus INtravascular ultrasound in percutaneous coronary interventiON) trial, a multicenter, prospective, randomized, noninferiority trial comparing optical frequency domain imaging (OFDI)-guided PCI with IVUS-guided PCI.

Background The impact of these 2 imaging modalities in guiding PCI remains unknown.

Methods Of 829 patients enrolled in the OPINION trial, 106 were included in the present imaging substudy. Their PCI was guided by either IVUS or OFDI, but all patients were imaged by both modalities after PCI and by OFDI at 8 months. Angiographic, OFDI, and IVUS images were analyzed by independent core laboratories, and statistical analysis was done independently by a dedicated institution.

Results A total of 103 patients underwent either OFDI-guided (n = 54) or IVUS-guided (n = 49) PCI. Immediately after PCI, OFDI-guided PCI was associated with a smaller trend of minimum stent area (5.28 ± 1.65 mm² vs. 6.12 ± 2.34 mm²; p = 0.088), fewer proximal stent-edge hematomas (p = 0.04), and fewer irregular protrusions (p = 0.014) than IVUS-guided PCI. At 8 months, the neointima area tended to be smaller in the OFDI-guided PCI group than in the IVUS-guided PCI group (0.56 ± 0.30 mm² vs. 0.80 ± 0.65 mm²; p = 0.057), although the percentage of uncovered struts was significantly higher in the OFDI-guided PCI group than in the IVUS-guided PCI group (6.97 ± 7.03% vs. 4.67 ± 6.43%; p = 0.039). The minimum lumen area was comparable in both groups (p = 0.18).

Conclusions There were several differences in local findings between OFDI- and IVUS-guided PCI as expected given the different protocols for stent sizing in the 2 groups. The minimum lumen area at the 8-month follow-up was comparable, suggesting that OFDI- and IVUS-guided PCI are similarly feasible using the current-generation drug-eluting stents. (OPtical frequency domain imaging versus INtravascular ultrasound in percutaneous coronary interventiON; NCT01873222)

目的作者试图阐明在OPINION的预先指定子研究（光学频域成像与经皮血管内超声对比）中，血管内超声（IVUS）和光学相干断层扫描如何影响当前使用药物洗脱支架的经皮冠状动脉介入治疗（PCI）。冠状动脉介入试验），一项将光频域成像（OFDI）引导的PCI与IVUS引导的PCI进行比较的多中心，前瞻性，随机，非劣效性试验。

背景技术这两种成像方式对指导PCI的影响尚不清楚。

方法参加OPINION试验的829例患者中，有106例包括在本成像研究中。他们的PCI由IVUS或OFDI指导，但所有患者均在PCI后和8个月时通过OFDI两种方式进行成像。血管造影，OFDI和IVUS图像由独立的核心实验室进行分析，统计分析由专门的机构独立进行。

结果共有103例患者接受了OFDI引导（n = 54）或IVUS引导（n = 49）的PCI。PCI后立即进行OFDI引导的PCI，其最小支架面积趋势较小（5.28±1.65 mm ² vs. 6.12±2.34 mm ²； p = 0.088），近端支架边缘血肿（p = 0.04）和与IVUS引导的PCI相比，更少的不规则突起（p = 0.014）。在8个月时，OFDI引导的PCI组的新生内膜面积倾向于小于IVUS引导的PCI组（0.56±0.30 mm ²对0.80±0.65 mm ²; p = 0.057），尽管OFDI引导的PCI组的裸露支杆百分比明显高于IVUS引导的PCI组（6.97±7.03％vs. 4.67±6.43％； p = 0.039）。两组的最小管腔面积相当（p = 0.18）。

结论在OFDI和IVUS引导的PCI之间，由于两组支架尺寸不同的协议，局部发现存在一些差异。在8个月的随访中，最小管腔面积具有可比性，这表明使用当前药物洗脱支架，OFDI和IVUS引导的PCI同样可行。（经皮冠状动脉介入治疗的光学频域成像与血管内超声对比; NCT01873222）