Optical coherence tomography guided carotid artery stent procedure: technique and potential applications

Publisher： John Wiley & Sons Inc

E-ISSN： 1522-726x|91|3|521-530

ISSN： 1522-1946

Source： CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, Vol.91, Iss.3, 2018-02, pp. : 521-530

Disclaimer: Any content in publications that violate the sovereignty, the constitution or regulations of the PRC is not accepted or approved by CNPIEC.

Previous Menu Next

Abstract

Abstract

ObjectivesTo (1) present a guide on how to perform optical coherence tomography (OCT) in carotid artery stenting (CAS), to (2) highlight several instructive cases illustrating OCT‐guidance as an interventional strategy, and to (3) present the largest case‐series of OCT‐guided CAS performed in North America, demonstrating its feasibility as an imaging modality in this setting.
BackgroundOCT is an intravascular imaging method that captures images with an axial resolution 10 times higher than intravascular ultrasound. OCT has proven to be a useful modality in coronary angiography and may have similar applications in evaluating carotid atherosclerotic disease.
MethodsWe compared our experience in CAS utilizing OCT (40 patients) versus that of CAS without OCT guidance (52 patients).
ResultsNo strokes or deaths occurred in either group postprocedurally or at 12 months. Fluoroscopy time was reduced in the OCT arm (14 ± 1 vs. 16 ± 1 min). Postprocedural creatinine levels were identical (1 ± 0 mg/dl, P = 0.96). Procedure time (96 ± 8 vs. 80 ± 3 min, P = 0.06) and contrast use (94 ± 4 vs. 83 ± 4 ml, P = 0.05) was slightly elevated in the OCT arm.
ConclusionsWe established a standardized protocol to consistently obtain OCT images that helped guide interventional decision‐making during CAS. OCT imaging in the carotids requires a higher contrast load and prolongs procedure time. However, it can be performed without significant increases in fluoroscopy time or negatively affecting renal function. There were no negative safety signals in this pilot study.

Related content

Is optical coherence tomography a coherent strategy for carotid artery stenting?

By  

CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, Vol. 91, Iss. 3, 2018-02 ,pp. : 531-532 (2)

John Wiley & Sons Inc

Access to resources Recommend Favorite

Impact of coronary artery stent edge dissections on long‐term clinical outcome in patients with acute coronary syndrome: An optical coherence tomography study

By  

CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, Vol. 86, Iss. 2, 2015-08 ,pp. : 237-246 (10)

John Wiley & Sons Inc

Access to resources Recommend Favorite

Automatic detection of stent struts with thick neointimal growth in intravascular optical coherence tomography image sequences

By Xu Chenyang   Schmitt Joseph M   Akasaka Takashi   Kubo Takashi   Huang Kun  

Physics in Medicine and Biology, Vol. 56, Iss. 20, 2011-10 ,pp. : 6665-6675 (11)

IOP Publishing

Access to resources Recommend Favorite

Assessment of Characteristics of Neointimal Hyperplasia after Drug-Eluting Stent Implantation in Patients with Diabetes Mellitus: An Optical Coherence Tomography Analysis

By  

Cardiology, Vol. 128, Iss. 1, 2014-02 ,pp. : 34-40 (7)

Karger

Access to resources Recommend Favorite

Identification of Intrastent Pathology Associated With Late Stent Thrombosis Using Optical Coherence Tomography

By  

JOURNAL OF INTERVENTIONAL CARDIOLOGY, Vol. 28, Iss. 5, 2015-10 ,pp. : 439-448 (10)

John Wiley & Sons Inc

Access to resources Recommend Favorite