title: Immediate results of bifurcational stenting assessed with optical coherence tomography.
abstract: BACKGROUND
  A tubular stent may adapt with difficulty to coronary bifurcation lesions (CBLs).
  
  
  METHODS
  Time domain or frequency domain (FD) optical coherence tomography (OCT) was performed to assess strut apposition immediately after stent implantation across four segments inside the bifurcation, in a consecutive series of patients. OCT pullbacks were performed in the main vessel (MV).
  
  
  RESULTS
  A total of 13,142 struts in 45 CBL in 41 patients were assessed. Strut malapposition was significantly more frequent in the half bifurcation facing the side-branch (SB) ostium (42.9%) than in the proximal segment of the bifurcation 11.8%, half bifurcation opposite the SB 6.7%, or the distal segment 5.7% (all P < 0.0001). Lesions (n = 15) treated with stenting of both MV and SB had a total higher rate of malapposition than those (n = 30) treated with stenting of the MV only (17.6% vs. 9.5%; P = 0.0014). In latter group, lesions treated with FD-OCT-guided stent implantation (n = 13) presented a lower rate of malapposition than those treated with conventional angiographic-guided stent implantation (n = 17) (7.1% vs. 17.5%; P = 0.005).
  
  
  CONCLUSIONS
  In CBL, strut malapposition is particularly high at the SB ostium. However, a strategy of stenting MV only with adjunctive FD-OCT guidance is associated with lower rates of malapposition.
authors.affiliation: Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, London, UK.
authors.forename: Nicola
authors.initials: N
authors.lastname: Viceconte
authors.forename: Pawel
authors.initials: P
authors.lastname: Tyczynski
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Ferrante
authors.forename: Nicolas
authors.initials: N
authors.lastname: Foin
authors.forename: Pak Hei
authors.initials: PH
authors.lastname: Chan
authors.forename: Eduardo Alegrìa
authors.initials: EA
authors.lastname: Barrero
authors.forename: Carlo
authors.initials: C
authors.lastname: Di Mario
mesh_terms: D000368:Aged; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D003331:Coronary Vessels / Q000473:pathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D011184:Postoperative Period; D012189:Retrospective Studies; D015607:Stents; D013997:Time Factors; D041623:Tomography, Optical Coherence / Q000379:methods*; D016896:Treatment Outcome