The Ability of Optical Coherence Tomography to Monitor Percutaneous Coronary Intervention: Detailed Comparison with Intravascular Ultrasound

Background We investigated the usefulness of optical coherence tomography (OCT) to evaluate vessel response after stent implantation by comparing with that of intravascular ultrasound (IVUS) Methods and Results Eighteen cases undergoing percutaneous coronary intervention (PCI) who provided consent for both IVUS and OCT usage pre- and post PCI procedure were enrolled The lumen area at the distal site of the culprit lesion was smaller on OCT images than on IVUS images due to proximal vessel occlusion whereas the lumen area at the proximal site of the lesion did not differ between OCI and IVUS images (distal site 4 6 +/- 2 0 vs 5 0 +/- 1 8 mm(2) p = 0 0004 proximal site 5 5 +/- 2 3 vs 5 6 +/- 2 3 mm(2) p = 0 8160) Stent malapposition was more frequently observed by OCT (30%) than by IVUS (5%, p = 0 0381) Stent edge dissection was not detected by IVUS but was detected in 10% by OCT Tissue pro lapse was identified in all stents by OCT and in 5% by IVUS Thrombus was observed in 15% by OCT and in 5% by IVUS Conclusions Proximal coronary occlusion during OCT imaging was possibly related to underestimation of vessel sizing at distal reference Our data suggested that OCT might provide more detailed information on the presence of tissue prolapse thrombus formation and edge dissection than IVUS Further study is warranted to assess its clinical utility