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Usefulness of optical coherence tomography with angiographic coregistration in the guidance of coronary stent implantation

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Abstract

Optical coherence tomography (OCT)-angiography coregistration during stent implantation may be useful to avoid geographical mismatch and incomplete lesion coverage. Untreated lipid-rich plaque at stent edge is associated with subsequent stent edge restenosis. The present study sought to compare the frequency of untreated lipid-rich plaque at the stent edge between OCT-guided percutaneous coronary intervention (PCI) with and without OCT-angiography coregistration. We investigated 398 patients who underwent OCT-guided stent implantation (n = 198 in the coregistration group, and n = 200 in the no coregistration group). In OCT after PCI, untreated lipid-lich plaque was identified by the maximum lipid arc > 180˚ in the 5-mm stent edge segment. The PCI-targeted lesion characteristics and stent length were not different between the coregistration group and the no coregistration group. The frequency of untreated lipid-rich plaque in either proximal or distal stent edge segment was significantly lower in the coregistration group than in the no coregistration group (16% vs. 26%, P = 0.015). The frequency of stent-edge dissection (5% vs. 6%, P = 0.516) and untreated stenosis (2% vs. 3%, P = 0.724) was low and without significant differences between the two groups. In OCT-guided PCI, the use of OCT-angiography coregistration was associated with a reduced frequency of untreated lipid-rich plaque at stent edges. OCT-angiography coregistration has a positive impact on PCI results.

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Abbreviations

OCT:

Optical coherence tomography

PCI:

Percutaneous coronary intervention

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Authors and Affiliations

  1. Department of Cardiovascular Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-8509, Japan

    Takashi Kubo, Yasushi Ino, Yasutsugu Shiono, Kosei Terada, Hiroki Emori, Daisuke Higashioka, Masahiro Takahata, Teruaki Wada, Kunihiro Shimamura, Amir Kh. M. Khalifa & Takashi Akasaka

  2. Department of Cardiovascular Medicine, Assiut University Hospitals, Assiut, Egypt

    Amir Kh. M. Khalifa

  3. Biomedical Instrument Institute, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China

    Shengxian Tu

Authors
  1. Takashi Kubo
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  2. Yasushi Ino
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  3. Yasutsugu Shiono
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  4. Kosei Terada
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  5. Hiroki Emori
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  6. Daisuke Higashioka
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  7. Masahiro Takahata
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  8. Teruaki Wada
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  9. Kunihiro Shimamura
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  10. Amir Kh. M. Khalifa
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  11. Shengxian Tu
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  12. Takashi Akasaka
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Contributions

TK: contributed to study conception, data analysis and interpretation, and drafting of the manuscript. YI: performed OCT image analysis and reviewed and revised the manuscript. KT, HE, DH, MT, TW, KS, YS, AKMK, and ST reviewed and revised the manuscript. TA gave the final approval of the manuscript submitted.

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Correspondence to Takashi Kubo.

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Kubo, T., Ino, Y., Shiono, Y. et al. Usefulness of optical coherence tomography with angiographic coregistration in the guidance of coronary stent implantation. Heart Vessels 37, 200–207 (2022). https://doi.org/10.1007/s00380-021-01911-1

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  • DOI: https://doi.org/10.1007/s00380-021-01911-1

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