OCT Made Easy PDF download
OCT Made Easy PDF download Since its introduction in 1977, percutaneous coronary intervention (PCI) has undergone continued and pro- found advancements. The evolution of coronary devices, operator’s experience, interventional techniques, and adjunctive pharmacotherapy dramatically reduced the risks of early complications and improved long- term outcomes, elevating PCI to the predominant modality of invasive treatment of coronary artery disease (CAD) and one of the most frequently performed therapeutic interventions in medicine.
OCT Made Easy PDF download Although coronary angiography is the mainstay imaging modality to assess the presence, extent, and severity of CAD, and to guide PCI procedures, intravascular imaging has played a fundamental role during PCI maturation and evolution. Visual estimation of the planar silhouette of the contrast-filled luminogram may be insufficient for accurate diagnosis of CAD severity and extension, and oftentimes does not allow accurate planning and optimization of PCI. By providing higher-resolution tomographic images of the entire circumference of the vessel wall, intracoronary imaging may overcome these limitations.
OCT Made Easy PDF download In the mid-1990s—when coronary stents were plagued by elevated rates of acute or subacute throm- bosis, and oral anticoagulants were part of the adjunctive pharmacotherapy with its associated hemor- rhagic complications—Colombo .
OCT Made Easy PDF download demonstrated that despite an optimal angiographic result (<20% residual stenosis), only 30% of the stents implanted in 420 lesions were adequately expanded by intravas- cular ultrasound (IVUS). After IVUS-guided high-pressure balloon postdilatation, full expansion and complete stent apposition were achieved in 96% of the patients. This strategy resulted in very low rates of acute (0.6%) and subacute (0.3%) stent thrombosis, eliminating the need for systemic anticoagulants, and consolidating the widespread use of coronary stents for the percutaneous treatment of CAD in the years to come.
OCT Made Easy PDF download Although at rst sight the term stent planning may be viewed as a synonym for stent guidance, the two con- cepts are not always applied interchangeably. When it comes to the use of adjunctive intravascular imaging with the intention to guide coronary interventions, it is common practice to perform PCI based on angiog- raphy, and only execute intravascular imaging at the end of the procedure, to check the “ nal” PCI result. Although this approach offers the opportunity to optimize PCI, the planning strategy has been overlooked and restricted to the inherent limitations of angiography. As so, it is our opinion that the use of intravascular imaging for stent planning carries a much broader role, and intravascular imaging pre-PCI should not be underestimated.
OCT Made Easy PDF download Intravascular OCT pre-PCI allows accurate quanti cation of stenosis severity and extension, and charac- terization of the underlying plaque components and morphometry, helps locate adequate landing zones for the stent to be implanted, and provides accurate vessel sizing for selection of the stent length and diameter. It also allows up-front anticipation of the need for balloon postdilatation and the type and size of the balloon to be used. In other words, stent optimization can also be planned based on pre-PCI OCT imaging. After a sat- isfactory angiographic result has been achieved, post-PCI OCT can be performed to check on the procedure results, and judge whether further iterations are still needed.