Is refined OCT guidance of stent implantation needed?
The development of optical coherence tomography (OCT) provides new opportunities for the evaluation of coronary stents. Having a much higher spatial resolution than intravascular ultrasound (IVUS), OCT is currently used for long-term assessment of stent implantation. In the immediate future, however, it is quite likely that OCT will be used synergically with IVUS to optimise stent deployment; the criteria for optimising stent implantation using OCT will be clearly indebted to the evidence gathered with IVUS, with an added value in contexts like ambiguous images presenting after stenting, or in complex percutaneous coronary interventions (PCI) procedures like bifurcation stenting. However, since OCT is capable of identifying, during PCI, findings of potential relevance beyond the resolution IVUS, such as thrombus or tissue protrusion, intra-stent or edge dissections, or specific patterns of hyperplasia in restenotic lesions, it is foreseeable that new OCT-specific recommendations for optimal stent implantation will be made in the near future.
Gonzalo
Nieves
N
Interventional Cardiology, Hospital Clínico Universitario San Carlos, Madrid, Spain. nieves_gonzalo@yahoo.es
Escaned
Javier
J
Alfonso
Fernando
F
Jiménez-Quevedo
Pilar
P
Zakhem
Brian
B
Bañuelos
Camino
C
Hernández-Antolín
Rosana
R
Macaya
Carlos
C
D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation*; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000175:diagnosis / Q000209:etiology; D023921:Coronary Stenosis / Q000175:diagnosis* / Q000628:therapy*; D006801:Humans; D006965:Hyperplasia; D011237:Predictive Value of Tests; D011475:Prosthesis Failure; D012720:Severity of Illness Index; D015607:Stents; D013927:Thrombosis / Q000175:diagnosis / Q000209:etiology; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional