Quantitative analysis of intracoronary optical coherence tomography measurements of stent strut apposition and tissue coverage
Section snippets
Methods
A total of 30 patients were prospectively included in this study. OCT was performed immediately after stent deployment in 14 patients and on follow-up angiography in a separate group of 16 patients, using the LightLab system (Westford, Massachusetts, US). Blood clearance was achieved using a proximal occlusion balloon (Helios, Goodman, Japan) with intra-coronary flush of lactated Ringer's solution through the end-hole of the balloon catheter (flow rate 0.6–0.9 ml/s) during simultaneous image
Acute stent strut apposition
Clinical and angiographic and procedural characteristics of the 14 patients having OCT immediately following stent implantation are shown in Table 1. The target vessel was the left anterior descending artery (LAD) in 50%, left circumflex artery (LCx) in 21.4% and the right coronary artery (RCA) in 28.6%. OCT was performed uneventfully in all cases.
A mean of 3930 struts were examined by observer 1 and 4042 by observer 2. The average percent embedded, protruding and malapposed struts for observer
Discussion
This is the first systematic study to evaluate inter and intra-observer variability for both acute stent apposition and late tissue stent strut coverage using OCT. With its high resolution, OCT permits a detailed assessment of coronary structures while giving unique insights into tissue responses following stent implantation. Our study shows that OCT analysis gives highly reproducible data for both the assessment of acute stent strut apposition and late strut tissue coverage.
Conclusions
Low intra and interobserver variability can be expected when analyzing intracoronary derived OCT data for stent strut apposition and intimal coverage. This supports the validity of OCT as a clinical and research tool in the setting of intracoronary stent imaging.
Acknowledgement
The authors of this manuscript have certified that they comply with the Principles of Ethical Publishing in the International Journal of Cardiology [21].
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