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?:abstract
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Background: The use of optical coherence tomography−angio co-registration (OCT-ACR) in routine clinical practice is evolving with limited reporting of clinical outcomes We conducted this study to evaluate the impact of OCT-ACR on clinician decision making during percutaneous coronary intervention (PCI) Methods: Patients with clinically significant stenosis of >70% in at least 1 coronary artery were enrolled in the study The pre- and post-PCI procedural strategies were prospectively assessed after angiography, OCT, and ACR with data analyzed by an independent core lab We enrolled 500 patients from 9 centers in south Asia Twenty-eight patients had inadequate imaging, whereas data from 75 patients are yet to be analyzed by core lab due to COVID-19 Results: The interim results included 397 patients with a mean age of 57 8 ± 10 8 years Pre-procedural OCT resulted in a change in PCI strategy in 76% of lesions including change in stent length (57%), diameter (34%), strategy (10%), and landing zone (57%) (Figure) The use of ACR additionally altered treatment strategy in 23% lesions Postprocedural OCT demonstrated edge dissections (3%), underexpansion (18%), malapposition (17%), tissue/thrombus prolapse (8%), and incomplete coverage (1%), thereby requiring additional interventions for optimization in 36% lesions No change in strategy was observed with post-procedural ACR [Formula presented] Conclusion: This is the first South Asian study reporting outcomes of OCT-ACR−guided PCI in patients with coronary artery disease The use of OCT resulted in overall pre-procedural change of PCI strategy in 76% lesions compared with angiography Real-time ACR had an additional significant impact with change in strategy in 23% of lesions Categories: IMAGING: Imaging: Intravascular
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