Trends and outcomes of optical coherence tomography use: 877 patients single-center experience

Francesco Burzotta, Carlo Trani, Filippo Crea, Cristina Aurigemma, Antonio Maria Leone, Giampaolo Niccoli, Italo Porto

Risultato della ricerca: Contributo in rivistaArticolo in rivista

2 Citazioni (Scopus)

Abstract

Background: Optical-coherence-tomography (OCT) is an emerging invasive coronary imaging with still undefined clinical value. Recent data have underlined daily impact of such technique in several clinical settings such as acute coronary syndromes (ACS) and percutaneous coronary intervention (PCI) guidance. We aimed at assessing the trends and outcomes of OCT use in a high-volume percutaneous coronary interventions (PCI)-center. Methods: Over 6 years, 1025 coronary artery segments in 877 patients underwent OCT evaluation. Clinical and procedural characteristics were prospectively collected. Clinical setting for OCT was: “Diagnostic OCT” (OCT for lesion evaluation after coronary angiography without further PCI); “PCI-guidance OCT” (OCT as a guidance for complex PCI, both by intention or after diagnostic OCT). Primary study end-point was the occurrence of target-vessel-failure (TVF) during the follow-up. Results: Overall, OCT was successful in 99.1% of attempted lesions. Only one complication (coronary dissection requiring urgent PCI) occurred during OCT. After a follow-up of 695 ± 562 days, TVF occurred in 8.2% of cases. Despite similar baseline characteristics, TVF-free survival curves were different in the two populations (5.4% after diagnostic OCT and 9.9% after PCI-guidance OCT). Minimal-lumen-area (MLA) of target lesion was independently associated with TVF (HR 0.7, 95% CI 0.6–0.8). This was mainly driven by a significant impact of MLA in patients not revascularized (HR 0.6, 95% CI 0.4–0.9). TVF did not change according to the study period despite the selection of patients with increasing complexity. Conclusions: OCT has a good safety profile across a broad spectrum of patients encountered in daily practice. The easy-to-assess MLA parameter may help stratify prognosis of patients undergoing OCT. These data call for further evaluations of OCT clinical impact. OCT is a light-based imaging tool which had subvert the quite ordinary world of coronary imaging and the present study evaluates OCT use in a high-volume center. Our results suggest that application of OCT in “real world” patients presenting higher risk has a good safety profile. Several factors could predict a worse long-term outcome in patients undergoing OCT evaluation, mostly related to more complex clinical conditions. These findings could encourage even low-to intermediate volume centers to improve their OCT use in daily practice.
Lingua originaleEnglish
pagine (da-a)303-310
Numero di pagine8
RivistaCardiovascular Revascularization Medicine
Volume20
DOI
Stato di pubblicazionePubblicato - 2019

Keywords

  • Optical coherence tomography
  • Treatment Outcome
  • Trends and outcomes
  • Aged
  • Clinical Decision-Making
  • Coronary Artery Disease
  • Female
  • Hospitals, High-Volume
  • Humans
  • Male
  • Middle Aged
  • Outcome and Process Assessment, Health Care
  • Percutaneous Coronary Intervention
  • Predictive Value of Tests
  • Retrospective Studies
  • Risk Factors
  • Rome
  • Time Factors
  • Tomography, Optical Coherence
  • Percutaneous coronary interventions

Fingerprint Entra nei temi di ricerca di 'Trends and outcomes of optical coherence tomography use: 877 patients single-center experience'. Insieme formano una fingerprint unica.

Cita questo