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Importance of Routine Use of OCT in Bifurcation

Importance of Routine Use of OCT in Bifurcation

European Bifurcation Club 2014, EBC 2014 – Bordeaux, France

LIVE BIFURCATION STENTING GUIDANCE: OCT, IVUS, FFR & ANGIO

Importance of Routine Use of OCT in Bifurcation

Author: Yoshinobu Murasato, MD, PhD, Kyushu Medical Center, Fukuoka, Japan

 

TIPS & TRICKS IN ROUTINE USE OF OCT

  • Decrease contrast medium
    • Flow reduction: 5-10ml at 2-3ml/sec
    • Low-molecular dextran
  • GC engage: relatively deep
  • Avoid the patients unsuitable for the OCT examination
    • Ostial lesion in the LMCA and RCA
    • Diffuse diseased vessel
    • CKD stage 3b, 4

CONCLUSION

  • Routine use of OCT can provide useful information in vessel condition before and after treatment, which changes the strategy in 50% of the cases.
  • It can correct stent malapposition and underexpansion, which may lead to a decrease in cardiac death/MI.
  • A decrease in contrast medium or use of dextran can afford to more frequent OCT pull-backs for further examination in the complicated lesion.
  • 3-D OCT imaging has a possibility to correct GW recrossing point, which leads to decrease in incomplete stent apposition, however, it still requires innovation of image qualities.

 

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