Impact of IVUS and OCT on physician decision-making during post-PCI optimization.
Cardiovasc Revasc Med
; 55: 96-98, 2023 10.
Article
em En
| MEDLINE
| ID: mdl-37394321
ABSTRACT
BACKGROUND:
Intravascular imaging (IVI) has been available as a complementary diagnostic tool in addition to coronary angiography for more than two decades. Prior studies have suggested that IVI influences physician decision making in up to 27 % of cases during post-percutaneous coronary intervention (PCI) optimization. However, no studies have compared the two intracoronary imaging modalities (intravascular ultrasound [IVUS] vs. optical coherence tomography [OCT]) in shaping physician decisions post-PCI.METHODS:
We retrospectively analyzed IVI studies performed during PCI at a tertiary care center. IVUS and OCT cases performed by a single operator with expertise in both imaging studies were selected. The primary endpoint was the physician reaction rate during post-PCI optimization comparing IVUS vs. OCT.RESULTS:
A total of 142 patients underwent IVUS evaluation, and 146 underwent OCT evaluation, post-PCI. The primary endpoint did not differ between IVUS-guided vs OCT-guided PCI optimization (35.2 % vs. 31.5 %, p = 0.505). The predominant cause of abnormalities deemed unsatisfactory by the implanting physician warranting further intervention were stent under-expansion (26.1 % vs. 19.2 %, p = 0.163), followed by malapposition (2.1 % vs. 6.2 %, p = 0.085), and dissection (3.5 % vs 4.1 %, p = 0.794). Overall, IVI using either IVUS or OCT influenced the physician decision in 33.3 % of cases.CONCLUSION:
In this first study comparing IVUS- and OCT-guided PCI to assess their impact on physician decision making during post-PCI optimization, the primary endpoint of physician reaction rate was similar for IVUS vs. OCT. The use of post-PCI IVI changed physician management in one third of cases.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Doença da Artéria Coronariana
/
Intervenção Coronária Percutânea
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article