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.