title: 3D optical coherence tomography: new insights into the process of optimal rewiring of side branches during bifurcational stenting.
abstract: OBJECTIVE
  We describe three-dimensional optical coherence tomography (3D-OCT) guided bifurcation stenting and the clinical utility of 3D-OCT.
  
  
  RESULTS
  Twenty-two consecutive patients who underwent OCT examination to confirm the recrossing position after stent implantation in a bifurcation lesion were enrolled. Frequency domain OCT images were obtained to check the recrossing position and 3D reconstructions were performed off-line. The recrossing position was clearly visualised in 18/22 (81.8%) cases. In 13 cases, serial 3D-OCT could be assessed both before and after final kissing balloon post-dilation (FKBD). We divided these cases into two groups according to the presence of the link between hoops at the carina: free carina type (n=7) and connecting to carina type (n=6). All free carina types complied with the distal rewiring. The percentage of incomplete stent apposition (%ISA) of free carina type at the bifurcation segment after FKBD was significantly smaller than that of the connecting to carina type (0.7±0.9% vs. 12.2±6.5%, p=0.0074).
  
  
  CONCLUSIONS
  3D-OCT confirmation of the recrossing into the jailed side branch is feasible during PCI and may help to achieve distal rewiring and favourable stent positioning against the side branch ostium, leading to reduction in ISA and potentially better clinical outcomes.
authors: Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Japan.
authors: Takayuki
authors: T
authors: Okamura
authors: Yoshinobu
authors: Y
authors: Onuma
authors: Jutaro
authors: J
authors: Yamada
authors: Javaid
authors: J
authors: Iqbal
authors: Hiroki
authors: H
authors: Tateishi
authors: Tomoko
authors: T
authors: Nao
authors: Takamasa
authors: T
authors: Oda
authors: Takao
authors: T
authors: Maeda
authors: Takeshi
authors: T
authors: Nakamura
authors: Toshiro
authors: T
authors: Miura
authors: Masafumi
authors: M
authors: Yano
authors: Patrick W
authors: PW
authors: Serruys
mesh_terms: D000368:Aged; D060050:Angina, Stable / Q000209:etiology / Q000601:surgery; D000789:Angina, Unstable / Q000209:etiology / Q000601:surgery; D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000150:complications / Q000473:pathology / Q000601:surgery*; D023903:Coronary Restenosis; D003331:Coronary Vessels / Q000473:pathology*; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology / Q000601:surgery; D017202:Myocardial Ischemia / Q000209:etiology / Q000601:surgery*; D062645:Percutaneous Coronary Intervention / Q000379:methods; D025321:Surgery, Computer-Assisted / Q000379:methods*; D041623:Tomography, Optical Coherence / Q000379:methods*