title: Clinical utility of optical coherence tomography (OCT) in the optimisation of Absorb bioresorbable vascular scaffold deployment during percutaneous coronary intervention.
abstract: OBJECTIVE
  The Absorb everolimus-eluting bioresorbable vascular scaffold (BVS) represents an important advance in percutaneous coronary intervention (PCI) technology. With increasing use of BVS, it is important to understand its expansion characteristics to ensure optimal scaffold deployment. Optical coherence tomography (OCT) has been shown to improve detection of intraprocedural complications compared with conventional intravascular imaging modalities. This study aimed to determine whether or not OCT, post successful angiographic BVS implantation, influenced decision making with regard to the need for further scaffold optimisation.
  
  
  RESULTS
  Consecutive patients undergoing OCT-guided BVS implantation from August 2012 to March 2013 were reviewed to determine if further intervention was required to optimise BVS implantation, based on OCT performed after what was deemed to be an optimal angiographic result. Nineteen patients with 29 scaffolds were analysed. Mean age was 53.7, with 84% male. There was a range of lesion types with 12 (63%) type A and seven (37%) type B or C. Of 29 scaffolds analysed, 28% required further intervention after OCT review, three (37.5%) due to scaffold malapposition and five (62.5%) due to scaffold underexpansion.
  
  
  CONCLUSIONS
  Despite achieving angiographic success in all BVS implantations, further optimisation was required in over a quarter of patients on the basis of OCT findings.
authors.affiliation: Department of Cardiology, Royal North Shore Hospital, Sydney, Australia.
authors.forename: Usaid K
authors.initials: UK
authors.lastname: Allahwala
authors.forename: James A
authors.initials: JA
authors.lastname: Cockburn
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Shaw
authors.forename: Gemma A
authors.initials: GA
authors.lastname: Figtree
authors.forename: Peter S
authors.initials: PS
authors.lastname: Hansen
authors.forename: Ravinay
authors.initials: R
authors.lastname: Bhindi
mesh_terms: D020341:Absorbable Implants; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D015331:Cohort Studies; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000188:drug therapy / Q000601:surgery*; D054855:Drug-Eluting Stents; D000068338:Everolimus / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D012189:Retrospective Studies; D025321:Surgery, Computer-Assisted; D054457:Tissue Scaffolds; D041623:Tomography, Optical Coherence / Q000379:methods*
chemical_list: D000970:Antineoplastic Agents; D000068338:Everolimus