Open Access
01-02-2021 | Angiography | Original Paper
Impact of real-time angiographic co-registered optical coherence tomography on percutaneous coronary intervention: the OPTICO-integration II trial
Authors:
Vera S. Schneider, Felix Böhm, Katharina Blum, Matthias Riedel, Youssef S. Abdelwahed, Jens Klotsche, Julia K. Steiner, Andrea Heuberger, Carsten Skurk, Hans-Christian Mochmann, Alexander Lauten, Georg Fröhlich, Ursula Rauch-Kröhnert, Arash Haghikia, David Sinning, Barbara E. Stähli, Ulf Landmesser, David M. Leistner
Longitudinal geographic mismatch (LGM) as well as edge dissections are associated with an increased risk of adverse events after percutaneous coronary intervention (PCI). Recently, a novel system of real-time optical coherence tomography (OCT) with angiographic co-registration (ACR) became available and allows matched integration of cross-sectional OCT images to angiography. The OPTICO-integration II trial sought to assess the impact of ACR for PCI planning on the risk of LGM and edge dissections.
Methods
A total of 84 patients were prospectively randomized to ACR-guided PCI, OCT-guided PCI (without co-registration), and angiography-guided PCI. Primary endpoint was a composite of major edge dissection and/or LGM as assessed by post-PCI OCT.
Results
The primary endpoint was significantly reduced in ACR-guided PCI (4.2%) as compared to OCT-guided PCI (19.1%; p = 0.03) and angiography-guided PCI (25.5%; p < 0.01). Rates of LGM were 4.2%, 17.0%, and 22.9% in the ACR-guided PCI, in the OCT-guided PCI, and the angiography-guided PCI groups, respectively (ACR vs. OCT p = 0.04; ACR vs. angiography p = 0.04). The number of major edge dissections was low and without significant differences among the study groups (0% vs. 2.1% vs. 4.3%).
Conclusion
This study for the first time demonstrates superiority of ACR-guided PCI over OCT- and angiography-guided PCI in reducing the composite endpoint of major edge dissection and LGM, which was meanly driven by a reduction of LGM.
Impact of real-time angiographic co-registered optical coherence tomography on percutaneous coronary intervention: the OPTICO-integration II trial
Authors
Vera S. Schneider Felix Böhm Katharina Blum Matthias Riedel Youssef S. Abdelwahed Jens Klotsche Julia K. Steiner Andrea Heuberger Carsten Skurk Hans-Christian Mochmann Alexander Lauten Georg Fröhlich Ursula Rauch-Kröhnert Arash Haghikia David Sinning Barbara E. Stähli Ulf Landmesser David M. Leistner