CARDIOVASCULAR
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ABOUT OCT | OCT APPLICATIONS | CLINICAL OUTCOMES | EXPERT OPINION | OCT EDUCATION

About OPTICAL COHERENCE TOMOGRAPHY

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 burden for coronary artery disease. OCT provides automated, accurate measurements to help guide stent selection, placement, and deployment.


What are the applications of OCT for intravascular imaging?

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

  • Pre-PCI OCT (before stent implantation) helps to strategize treatment by determining and understanding plaque morphology, accurately sizing the vessel diameter1 and providing fast, automatic measurements of lumen, length and area.  Download Basics of OCT Image Interpretation Guide
  • Angiographic co-registration allows for precise stent placement by quickly correlating the angiographic view to the detailed OCT cross sectional and longitudinal views.
  • Post-PCI OCT (after stent implantation) helps to optimize stent placement for three key targets: expansion, apposition and dissection.
    • Automatic expansion calculations and detection of underexpanded regions with the recently launched AptiVue™ Software
    • Automatic identification of stent apposition with color-coded highlights
    • High resolution images to easily determine presence and severity of dissections
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.2-3 During percutaneous coronary intervention (PCI), stent underexpansion is an indicator of adverse events such as stent thrombosis and restenosis.4

 

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ULTIMATE Trial5

ULTIMATE is the most recent randomized, controlled trial demonstrating that patient outcomes improve when physicians achieve greater than 90% stent expansion, as an optimization target. 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

EXPERT OPINION

Common OCT Misconceptions Debunked by Experts

Watch physician experts Drs. Ziad Ali, Rich Shlofmitz, Ulf Landmesser and Jonathon 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 reflect the opinion or views of the Cardiovascular Research Foundation.

OCT Education

Watch OCT Videos on VuMedi

VuMedi is an online medical video education platform for healthcare providers. After creating a free account, you have access to a wide range of video content that’s available at any time and at your convenience.

On Abbott’s VuMedi Channel, you will find educational OCT videos:

 

Check back often as we add new videos to help you learn more about OCT.

 

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. Akiko Maehara, Gary S. Mintz, Gregg W. Stone OCT Versus IVUS: Accuracy Versus Clinical Utility JACC: Cardiovascular Imaging Oct 2013, 6 (10) 1105-1107; DOI: 10.1016/j.jcmg.2013.05.016
2. Byrne RA, et al. Stent thrombosis and restenosis: what have we learned and where are we going? Eur Heart J. 2015;36:3320-3331.
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(15 Suppl):B232.
4. 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.
5. 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

Request a Rep IMPORTANT SAFETY INFORMATION

IMPORTANT SAFETY INFORMATION

rx-only-logo OPTIS™ Imaging Systems and Software

INDICATIONS

The OPTIS™ Software and AptiVue™ E Series Software are intended to be used only with compatible OPTIS™ Imaging Systems.

The OPTIS™ Imaging System with a compatible Dragonfly™ Imaging Catheter is intended for the imaging of coronary arteries and is indicated in patients who are candidates for transluminal interventional procedures. The compatible Dragonfly™ Imaging Catheters are intended for use in vessels 2.0 to 3.5 mm in diameter. The compatible Dragonfly™ Imaging Catheters are not intended for use in the left main coronary artery or in a target vessel which has undergone a previous bypass procedure.

The OPTIS™ Imaging System is intended for use in the catheterization and related cardiovascular specialty laboratories and will further compute and display various physiological parameters based on the output from one or more electrodes, transducers, or measuring devices. The physician may use the acquired physiological parameters, along with knowledge of patient history, medical expertise and clinical judgment to determine if therapeutic intervention is indicated.

CONTRAINDICATIONS

The OPTIS™ Integrated System and Mobile System with Software are contraindicated where introduction of any catheter would constitute a threat to patient safety. Contraindications include:

  • Bacteremia or sepsis
  • Major coagulation system abnormalities
  • Patients diagnosed with coronary artery spasm
  • Patients disqualified for CABG surgery
  • Patients disqualified for PTCA
  • Severe hemodynamic instability or shock
  • Total occlusion
  • Large thrombus
  • Acute renal failure

NOTE: The systems have no patient alarm functions. Do not use for cardiac monitoring.

WARNINGS

  • Appropriate anticoagulant and vasodilator therapy must be used during the procedure as needed.
  • Observe all advancement and movement of the Dragonfly™ Imaging Catheter under fluoroscopy. Always advance and withdraw the catheter slowly. Failure to observe device movement fluoroscopically may result in vessel injury or device damage.
  • Leave the guidewire engaged with the catheter at all times during use. Do not withdraw or advance the guidewire prior to withdrawing the catheter.
  • If resistance is encountered during advancement or withdrawal of the Dragonfly™ Imaging Catheter, stop manipulation and evaluate under fluoroscopy. If the cause of resistance cannot be determined or mitigated, carefully remove the catheter and guidewire together.
  • The Dragonfly™ Imaging Catheter should never be forced into lumens that are narrower than the catheter body or forced through a tight or heavily calcified lesion.
  • The Dragonfly™ Imaging Catheter should not be advanced through abnormally tortuous anatomy.
  • When advancing or retracting a catheter with a monorail tip through a stented vessel, the catheter may engage the stent between the junction of the Dragonfly™ Imaging Catheter and guidewire, resulting in entrapment of catheter/guidewire, catheter tip separation, and/or stent dislocation.
  • Refer to the contrast media’s instructions-for-use for general warnings and precautions relating to use of the contrast media.
  • To protect the privacy and security of sensitive information, including electronic protected health information (EPHI), and to protect the integrity of the system itself, the system should be located in a physically secure, access controlled environment.
  • Do not use the OPTIS™ Imaging System if there is reason to believe the system's security has been compromised or if the system was unaccounted for a period of time (i.e. misappropriated, modified or tampered with).

PRECAUTIONS

  • Safety and effectiveness have been established for the following patient population: adult patients undergoing non-emergent percutaneous coronary interventions in lesions with reference vessel diameters between 2.0 to 3.5 mm, which were not located in the left main coronary artery or in a target vessel which has undergone previous bypass procedures.
  • For optimal imaging, only use 100% contrast media.
  • Store the Dragonfly™ Imaging Catheter at ambient temperature in a dry location out of direct sunlight.
  • Never attempt to attach or detach a Dragonfly™ Imaging Catheter to the DOC while the “lock” LED is lit.
  • Do not kink, sharply bend, pinch, or crush the Dragonfly™ Imaging Catheter at any time.
  • The Dragonfly™ Imaging Catheter is for single use only. Do not reuse, re-sterilize, or reprocess.
  • The Dragonfly™ Imaging Catheter is sterilized by ethylene oxide and is intended for one time use only. Non-pyrogenic. Do not use if the package is opened or damaged.
  • After use, the Dragonfly™ Imaging Catheter may be a potential biohazard. Handle and dispose of in accordance with accepted medical practice and applicable laws and regulations.
  • The Dragonfly™ Imaging Catheter has no user serviceable parts. Do not attempt to repair or alter any part of the catheter assembly as provided.

rx-only-logo Dragonfly™ OPTIS™ Imaging Catheter

INDICATIONS

The Dragonfly OPTIS Imaging Catheter with the OCT Imaging System is intended for the imaging of coronary arteries and is indicated in patients who are candidates for transluminal interventional procedures. The Dragonfly OPTIS Imaging Catheter is intended for use in vessels 2.0 to 3.5 mm in diameter. The Dragonfly OPTIS Imaging Catheter is not intended for use in the left main coronary artery or in a target vessel which has undergone a previous bypass procedure.

CONTRAINDICATIONS

Use of the Dragonfly OPTIS Imaging Catheter is contraindicated where introduction of any catheter would constitute a threat to patient safety. Contraindications include:

  • Bacteremia or sepsis
  • Major coagulation system abnormalities
  • Patients disqualified for CABG surgery
  • Patients disqualified for PTCA
  • Severe hemodynamic instability or shock
  • Patients diagnosed with coronary artery spasm
  • Total occlusion
  • Large thrombus
  • Acute renal failure

WARNINGS AND PRECAUTIONS

  • Store at ambient temperature in a dry location out of direct sunlight.
  • Ensure the catheter is at room temperature (10°C to 32°C) before use.
  • This device is sterilized by ethylene oxide and is intended for one time use only. Non-pyrogenic. Do not use if the package is opened or damaged. Do not reuse or re-sterilize.
  • Appropriate anticoagulant and vasodilator therapy must be used during the procedure as needed.
  • Observe all advancement and movement of the Dragonfly OPTIS Imaging Catheter under fluoroscopy. Always advance and withdraw the catheter slowly. Failure to observe device movement fluoroscopically may result in vessel injury or device damage. To assure proper placement do not move the guide wire after the Dragonfly OPTIS Imaging Catheter is in place.
  • If resistance is encountered during advancement or withdrawal of the Dragonfly OPTIS Imaging Catheter, stop manipulation and evaluate under fluoroscopy. If the cause of resistance cannot be determined or mitigated, carefully remove the catheter from the patient.
  • Use the minimum flush rate and volume required to image the desired anatomy.
  • After use, this product may be a potential biohazard. Handle and dispose of in accordance with accepted medical practice and applicable laws and regulations.
  • The instructions for use are recyclable. Dispose of all packaging materials appropriately.
  • Refer to contrast media Instructions for Use for general warnings and precautions relating to contrast media.
  • This package contains a Sterile Single Use Only Device. Any attempt to re-use or re-sterilize may compromise the structural integrity of this device.
  • Do not remove the Dragonfly OPTIS Imaging Catheter from the DOC until the procedure is complete to avoid a potential sterility breach.
  • Always verify that the catheter has been properly prepared prior to inserting into vasculature.

POTENTIAL ADVERSE EVENTS

The following complications may occur as a consequence of intravascular imaging:

  • Coronary artery spasm
  • Unstable angina
  • Allergic reaction to the contrast media
  • Arterial dissection, injury or perforation
  • Thrombus formation, abrupt closure, or total occlusion
  • Abnormal heart arrhythmias
  • Embolism
  • Acute myocardial infarction
  • Death

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DO YOU WISH TO CONTINUE AND EXIT CARDIOVASCULAR.ABBOTT?

CONTENTS OF THE SITE ARE NOT UNDER THE CONTROL OF ABBOTT.