Percutaneous coronary intervention (PCI) guided by optical coherence tomography (OCT) reduces adverse cardiac events in patients with bifurcation lesions, according to late breaking research presented in a Hot Line session August 27 at ESC Congress 2023.
Percutaneous coronary intervention guided by optical coherence tomography reduces adverse cardiac events in patients with bifurcation lesions, according to late breaking research presented in a Hot Line session August 27 atIn approximately 15%–20% of coronary revascularizations performed by PCI, the lesion is located in a branch point of the coronary arteries.
Patients with complex bifurcation lesions requiring PCI were randomly allocated in a 1:1 ratio to OCT-guided PCI or angiography-guided PCI. OCT-guided PCI was performed according to a detailed treatment protocol which included stepwise evaluation of lesion preparation, lesion length, reference sizes, lesion coverage, stent expansion, malapposition, wire positions, and ostial results. Investigators received training and core lab feedback on OCT-guided procedures throughout the trial.
The trial included 1,201 patients from 38 heart centers across 13 European countries. A total of 600 patients were allocated to OCT-guided PCI and 601 patients were allocated to angiography-guided PCI. The average age of participants was 66 years, and 21% of patients in both groups were women. There were no apparent differences in procedural safety, but the volume of contrast and the procedure time were both increased with OCT-guided PCI compared with angiography-guided PCI.
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