CARDIOVASCULAR
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About OPTICAL COHERENCE TOMOGRAPHY (OCT)

What is OCT?

Optical Coherence Tomography (OCT) is an imaging modality that uses near-infrared light to provide high-definition images of the artery with high precision allowing to access lesion characteristics and plaque morphology for coronary artery disease. OCT provides automated, accurate measurements to help guide stent selection, placement, and deployment.1


Are you seeing what you need to see using Angiography alone?

OCT imaging can be used pre and post-PCI (percutaneous coronary interventions) to guide procedure planning and treatment decisions.2

 

Pre-PCI Post-PCI
Identifying and understanding Plaque morphology Optimize stent placement
Accurately sizing vessel diameter Determine stent expansion – automatic calculation and detection of underexpanded regions
Quick and automated lumen, length and area measurements Detecting stent apposition – color coded for easier visualization
Angio co-registration for precise stent placement Identify presence and severity of edge dissection – with high resolution images


 

How to optimize PCI with OCT imaging steps

Clinical Outcomes

Does intravascular imaging improve outcomes?

Achieving optimal expansion is proven to reduce rates of adverse cardiac events.3-4 During percutaneous coronary intervention (PCI), stent underexpansion is an indicator of adverse events such as stent thrombosis and restenosis.5

 

Stent Underexpansion is Established as a Major Predictor
of Stent Failure, Including Stent Thrombosis and Restenosis1

Image on file at Abbott

1. Räber L, et al. Clinical use of intracoronary imaging. Part 1: guidance and optimization of coronary interventions. An expert consensus document of the European Association of Percutaneous Cardiovascular Interventions. Eur Heart J. September 14, 2018;39(35):3281-3300.
2. Byrne RA, Joner M, Kastrati A. Stent thrombosis and restenosis: what have we learned and where are we going? The Andreas Grüntzig Lecture ESC 2014. Eur Heart J. December 14, 2015;36(47):3320-31.
3. von Birgelen C, et al. TCT-572 Final 5-Year Outcome After Implantation of Zotarolimus-Eluting Resolute Stents Versus Everolimus-Eluting Xience V Stents in the Broad Patient Population of the Randomized TWENTE Trial. J Am Coll Cardiol. 2015;66(Suppl 15).doi:10.1016/j.jacc.2015.08.1042.

 

ULTIMATE Trial6

ULTIMATE is a recent randomized, controlled clinical trial demonstrating that patient outcomes improve when physicians achieve greater than 90% stent expansion. Patients who reached these optimization targets were classified as “optimal PCI” cases and did significantly better than those who did not reach optimized targets.

 

Optical coherence tomography, ULTIMATE trial demonstrates that targeting optimal stent expansion though imaging improves outcomes


 

optical coherence tomography, ULTIMATE trial demonstrates that targeting optimal stent expansion though imaging improves outcomes

Note: Results from clinical trials are not directly comparable. Information provided for educational purposes only.

1. Zhang et al., Intravascular Ultrasound Versus Angiography-Guided Drug-Eluting Stent Implantation. ULTIMATE, JACC, 2018
2. Dohi, Etiology, Frequency, and Clinical Outcomes of Myocardial Infection After Successful Drug-Eluting Stent Implantation Two-Year Follow-Up From the ADAPT-DES Study Cardiac Catheterization, 2019.
3. Hong M et al. IVUS XPL 5 Year Outcomes, TCT2019

EXPERT OPINION

Common OCT Misconceptions Debunked by Experts

Watch physician experts Drs. Ziad Ali, Rich Shlofmitz, Ulf Landmesser and Jonathan Hill discuss application of Optical Coherence Tomography (OCT) intravascular imaging in daily practice for percutaneous coronary interventions, and address such questions as contrast use, cost, procedural time and recommendation on using OCT in the cath lab.

 

This course was recorded at TCT 2017 and does not reflect the opinion or views of the Cardiovascular Research Foundation.

This course was recorded at TCT 2017 and does not necessarily reflect the opinion or views of the Cardiovascular Research Foundation.

OCT Education

Social Media

Follow  @AbbottCardio and join the conversation about intravascular imaging. Follow #OCTimaging #imagefirst #imagelast hashtags.

Learn more about OCT via these tweetorials we have published on Twitter:

 
 

References
  1. Reyes, M. The next innovation in PCI is not a stent. The value of OCT. CathLab Digest. Oct 6, 2019. Volume 27, Issue 10.
  2. Bezerra, H. Intravascular OCT in PCI. American College of Cardiology. June 13, 2016.
  3. Byrne RA, et al. Stent thrombosis and restenosis: what have we learned and where are we going? Eur Heart J. 2015;36:3320-3331.
  4. von Birgelen C, et al. TCT-572 final 5-year outcome after implantation of zotarolimus-eluting Resolute stents versus everolimus-eluting Xience V stents in the broad patient population of the randomized TWENTE trial. J Am Coll Cardiol. 2015;66(15 Suppl):B232.
  5. Räber L, et al. Clinical use of intracoronary imaging. Part 1: guidance and optimization of coronary interventions. An expert consensus document of the European Association of Percutaneous Cardiovascular Interventions. Eur Heart J. 2018;39(35):3281-3300.
  6. Zhang J, et al. Intravascular ultrasound versus angiography-guided drug-eluting stent implantation: the ULTIMATE trial. J Am Coll Cardiol. 2018;72(24):3126-3137
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