A multicentre evaluation of the safety of intracoronary optical coherence tomography.
OBJECTIVE
Optical coherence tomography (OCT) is increasingly being applied to the coronary arteries. However, the risks associated with the imaging procedure are not yet well defined. The purpose of the present multicentre registry was to assess the acute complications associated with the clinical use of intra-coronary OCT in a large number of patients.


RESULTS
Consecutive patients from six centres who had OCT examination were retrospectively included. All adverse events and complications, even if transient, were noted. Risks were categorised into: 1) self-limiting 2) major complications including major adverse cardiac events (MACE) and 3) mechanical device failure. A total of 468 patients underwent OCT examination for evaluation of: plaque (40.0%), percutaneous coronary intervention (28.2%) or follow-up stent tissue coverage (31.8%). OCT was performed using a non-occlusive flush technique in 45.3% with a mean contrast volume of 36.6+/-9.4ml. Transient chest pain and QRS widening/ST-depression/elevation were observed in 47.6% and 45.5% respectively. Major complications included five (1.1%) cases of ventricular fibrillation due to balloon occlusion and/or deep guide catheter intubation, 3 (0.6%) cases of air embolism and one case of vessel dissection (0.2%). There were no cases of coronary spasm or MACE during or within the 24 hour period following OCT examination.


CONCLUSIONS
OCT is a specialised technique with a relatively steep learning curve. Major complications are uncommon and can be minimised with careful procedural planning and having an awareness of the potential contributory risks, especially deep guide catheter intubation during contrast flushing. Upcoming developments will make OCT more practical and less procedurally demanding, also potentially conserving contrast volume considerably.
Barlis
Peter
P
Thoraxcenter, Erasmus Medical Centre, Rotterdam, The Netherlands.
Gonzalo
Nieves
N
Di Mario
Carlo
C
Prati
Francesco
F
Buellesfeld
Lutz
L
Rieber
Johannes
J
Dalby
Miles C
MC
Ferrante
Giuseppe
G
Cera
Maria
M
Grube
Eberhard
E
Serruys
Patrick W
PW
Regar
Evelyn
E
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation; D002318:Cardiovascular Diseases / Q000209:etiology; D002983:Clinical Competence; D003287:Contrast Media; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000628:therapy; D003331:Coronary Vessels / Q000473:pathology*; D005060:Europe; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011475:Prosthesis Failure; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D015607:Stents; D041623:Tomography, Optical Coherence / Q000009:adverse effects; D016896:Treatment Outcome
D003287:Contrast Media