title: Impact of frequency-domain optical coherence tomography guidance for optimal coronary stent implantation in comparison with intravascular ultrasound guidance.
abstract: BACKGROUND
  Frequency-domain optical coherence tomography (FD-OCT) is a novel, high resolution intravascular imaging modality. Intravascular ultrasound (IVUS) is a widely used conventional imaging modality for achieving optimal stent deployment. The aim of this study was to evaluate the impact of FD-OCT guidance for coronary stent implantation compared with IVUS guidance.
  
  
  RESULTS
  A total of 70 patients with de novo coronary artery lesions and either unstable or stable angina pectoris were enrolled in this randomized study (optical coherence tomography [OCT] group: n=35, IVUS group: n=35). In the OCT group, stent implantation was performed under FD-OCT guidance alone and final stent expansion was evaluated by IVUS. In the IVUS group, conventional IVUS guidance was used and final stent apposition was evaluated by FD-OCT. There were no significant differences regarding the procedural, fluoroscopy time, and contrast volume. Although device and clinical success rates also were similar, the visibility of vessel border was significantly lower in the OCT group (P<0.05). Minimum and mean stent area and focal and diffuse stent expansion were smaller (6.1±2.2 mm versus 7.1±2.1 mm, 7.5±2.5 versus 8.7±2.4 mm, 64.7±13.7% versus 80.3±13.4%, 84.2±15.8% versus 98.8±16.5%, P<0.05, respectively), and the frequency of significant residual reference segment stenosis at the proximal edge was higher in the OCT group (P<0.05). Incomplete apposed struts in both groups were similar (P=0.34).
  
  
  CONCLUSIONS
  FD-OCT guidance for stent implantation was associated with smaller stent expansion and more frequent significant residual reference segment stenosis compared with conventional IVUS guidance.
authors.affiliation: Department of Cardiovascular Medicine, Toyohashi Heart Center, Toyohashi, Japan.
authors.forename: Maoto
authors.initials: M
authors.lastname: Habara
authors.forename: Kenya
authors.initials: K
authors.lastname: Nasu
authors.forename: Mitsuyasu
authors.initials: M
authors.lastname: Terashima
authors.forename: Hideaki
authors.initials: H
authors.lastname: Kaneda
authors.forename: Daisuke
authors.initials: D
authors.lastname: Yokota
authors.forename: Euihong
authors.initials: E
authors.lastname: Ko
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Ito
authors.forename: Tairo
authors.initials: T
authors.lastname: Kurita
authors.forename: Nobuyoshi
authors.initials: N
authors.lastname: Tanaka
authors.forename: Masashi
authors.initials: M
authors.lastname: Kimura
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Ito
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Kinoshita
authors.forename: Etsuo
authors.initials: E
authors.lastname: Tsuchikane
authors.forename: Keiko
authors.initials: K
authors.lastname: Asakura
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Asakura
authors.forename: Osamu
authors.initials: O
authors.lastname: Katoh
authors.forename: Takahiko
authors.initials: T
authors.lastname: Suzuki
mesh_terms: D000368:Aged; D019917:Blood Vessel Prosthesis Implantation; D003324:Coronary Artery Disease / Q000473:pathology / Q000601:surgery*; D023903:Coronary Restenosis / Q000473:pathology / Q000601:surgery*; D003331:Coronary Vessels / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000473:pathology / Q000601:surgery*; D015607:Stents; D025321:Surgery, Computer-Assisted; D041623:Tomography, Optical Coherence / Q000379:methods; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional / Q000379:methods