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 August 27 at ESC Congress 2023. Stent thrombosis was significantly reduced with OCT-guided PCI.
Optical coherence tomography -guided percutaneous coronary intervention 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 August 27 athave demonstrated improved clinical outcomes with intravascular imaging-guided PCI compared with angiography guidance alone, including in complex patients.
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. Blinded OCT was performed after PCI in the angiography group to enable assessment of the first co-primary endpoint and other differences between the two treatment arms.
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 OCT-guided patients and in 17 angiography-guided patients .
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