Optical coherence tomography (OCT) is non-inferior to intravascular ultrasound (IVUS) for guiding percutaneous coronary intervention (PCI), according to late breaking research presented in a Hot Line session today at ESC Congress 2023.
IVUS and OCT have been increasingly used to guide PCI procedures. Both imaging techniques can be used to assess target lesion characteristics, optimize stent implantation and minimize stent-related problems. European and US guidelines recommend that IVUS or OCT be considered in selected patients to optimize stent implantation. However, the comparative effectiveness of these two contemporary imaging strategies for PCI guidance are still unknown.
The trial was an investigator-initiated, prospective, multicenter, randomized, open-label pragmatic trial conducted at nine sites in South Korea. It enrolled patients aged 19 years or older who were undergoing PCI with contemporary drug-eluting stents or drug-coated balloons for significant coronary artery lesions. As a pragmatic trial, the enrolment criteria were designed to capture a broad range of patients with various anatomical or clinical characteristics.
The primary endpoint was a composite of death from cardiac causes, target vessel myocardial infarction or ischemia-driven target vessel revascularisation at one year, which was powered for noninferiority of the OCT group as compared with the IVUS group . Related StoriesRegarding safety endpoints, the incidence of contrast-induced nephropathy was similar in the OCT and IVUS groups . The incidence of major procedural complications was lower in the OCT group compared with the IVUS group .
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