OCT-guided PCI does not reduce target vessel failure in complex patients, but improves safety

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OCT-guided PCI does not reduce target vessel failure in complex patients, but improves safety
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Optical coherence tomography (OCT)-guided percutaneous coronary intervention (PCI) leads to a larger minimum stent area but does not reduce the two-year rate of target vessel failure compared with angiography-guided PCI, according to late breaking research presented in a Hot Line session today at ESC Congress 2023.

Reviewed by Megan Craig, M.Sc.Aug 28 2023 Stent thrombosis was significantly reduced with OCT-guided PCI.

The trial enrolled patients with medication-treated diabetes and/or complex lesions at 80 sites in 18 countries. The investigators chose to include only complex patients and complex lesions as these patients were considered the most likely to gain the benefit of OCT guidance. Patients were randomized in a 1:1 ratio to OCT-guided PCI or angiography-guided PCI.

The trial included 2,487 patients, of whom 1,233 received OCT-guided PCI and 1,254 received angiography-guided PCI. The mean age of participants was 65.6 years and 22.6% were women. For efficacy, the minimum stent area achieved was larger in the OCT-guided group than in the angiography-guided group . Target vessel failure within two years occurred in 88 OCT-guided patients and 99 angiography-guided patients .

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