1
|
Huang J, Belmadani K, Chatot M, Ecarnot F, Chopard R, Wang M, Cai X, Schiele F, Meneveau N. Clinical significance of optical coherence tomography-guided angioplasty on treatment selection. Exp Ther Med 2018; 16:483-492. [PMID: 30116307 PMCID: PMC6090244 DOI: 10.3892/etm.2018.6237] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Accepted: 09/29/2017] [Indexed: 01/26/2023] Open
Abstract
The present study aimed to observe whether optical coherence tomography (OCT)-guided angioplasty is able to provide useful clinical information beyond that obtained by angiography as well as provide recommendations for physicians that may improve treatment selection. This prospective study included 83 patients with coronary artery disease (>18 years) undergoing coronary angiography (CAG) for ST-elevation myocardial infarction (n=13), non-ST-elevation myocardial infarction (n=19), stable angina (n=22), unstable angina (n=10), silent ischemia (n=11), or elective percutaneous coronary intervention (n=8). Following the initial CAG (CAG-pre), the patients underwent OCT before angioplasty (OCT-pre, 24 patients), after angioplasty (OCT-post, 22 patients), or both (37 patients). The thrombus burden, calcification and plaque dissection or rupture were compared between the OCT-pre and CAG-pre recordings. Following angioplasty, stent malapposition, suboptimal stent deployment, suboptimal stent lesion coverage, and edge dissection were compared between OCT-post and CAG-post alone. Among the 83 patients, 45.7% had single-vessel and 54.3% had multiple-vessel disease. OCT pre- and post-angioplasty revealed significantly more information on the procedure than CAG alone. This clinical information changed the clinical strategies in 41/83 (49.4%) patients, including 58 modifications of therapeutic strategy (69.9%, 58/83): Thrombus aspiration in 2 cases (2.4%), administration of glycoprotein IIb/IIIa inhibitors in 8 cases (9.6%), additional balloon inflation in 23 cases (27.7%), additional stent implantation in 17 cases (20.5%), avoiding stent implantation in 4 cases (4.8%), collateral intervention in 2 cases (2.4%), and guidewire reposition in 2 cases (2.4%). In conclusion, OCT-pre and OCT-post provided additional clinical information beyond that obtained by angiography alone, which resulted in modification of the treatment strategies in half of the included patients.
Collapse
Affiliation(s)
- Jianfeng Huang
- Department of Cardiology, University Hospital Jean-Minjoz, Besançon 25030, France.,Department of Cardiology, Yueqing Hospital, Wenzhou Medical University, Wenzhou, Zhejiang 325600, P.R. China
| | - Kamal Belmadani
- Department of Cardiology, University Hospital Jean-Minjoz, Besançon 25030, France
| | - Marion Chatot
- Department of Cardiology, University Hospital Jean-Minjoz, Besançon 25030, France
| | - Fiona Ecarnot
- Department of Cardiology, University Hospital Jean-Minjoz, Besançon 25030, France
| | - Romain Chopard
- Department of Cardiology, University Hospital Jean-Minjoz, Besançon 25030, France
| | - Manhong Wang
- Department of Cardiology, Yueqing Hospital, Wenzhou Medical University, Wenzhou, Zhejiang 325600, P.R. China
| | - Xu Cai
- Department of Cardiology, Ningbo University Hospital, Ningbo, Zhejiang 315000, P.R. China
| | - Francois Schiele
- Department of Cardiology, University Hospital Jean-Minjoz, Besançon 25030, France
| | - Nicolas Meneveau
- Department of Cardiology, University Hospital Jean-Minjoz, Besançon 25030, France
| |
Collapse
|
2
|
Hakeem A, Edupuganti MM, Almomani A, Pothineni NV, Payne J, Abualsuod AM, Bhatti S, Ahmed Z, Uretsky BF. Long-Term Prognosis of Deferred Acute Coronary Syndrome Lesions Based on Nonischemic Fractional Flow Reserve. J Am Coll Cardiol 2016; 68:1181-1191. [DOI: 10.1016/j.jacc.2016.06.035] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2016] [Revised: 06/07/2016] [Accepted: 06/13/2016] [Indexed: 11/29/2022]
|