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The role of OCT in optimization of bifurcation PCI

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European Bifurcation Club 2012 – EBC 2012 – Castelldefels, Spain

OCT imaging session

The role of OCT in optimization of bifurcation PCI

Author: Dr. Andrejs Erglis Latvian Centre of Cardiology, Pauls Stradins Clinical University Hospital, Riga, LATVIA

 

XIENCE OPTIMAL STUDY

  • Pilot, prospective, consecutive, one centre registry analyzing feasibility of OCT-guided XIENCE-PRIME stent implantation for the treatment of bifurcation coronary artery disease.
  • Study population: Elective patients with non-left main bifurcation coronary artery disease involving at least 2 segments of the bifurcation; Sample size 70
  •  Hypothesis:
    • Treatment of bifurcation coronary disease with XIENCE PRIME is safe andfeasible with similar performance (non-inferior) to historical control
    • Acute and long-term outcomes of OCT-guided bifurcation treatment with XIENCE PRIME will be better than angiography guided treatment in historical control

CONCLUSION

  • Intravascular optical coherence tomography (OCT) enables highly detailed assessment of lumen and calcium after different plaque modification strategies
  • In Xience Optimal study, after plaque modification with angiosculpt or cutting balloon OCT revealed dissections in all patients, there was trend to higher rate of calcium fractures after cutting balloon
  • OCT may improve our understanding of lesion morphology and is hypothesis rising for novel treatment strategies

 

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