Author + information
- Received May 23, 2017
- Revision received August 11, 2017
- Accepted September 28, 2017
- Published online December 4, 2017.
- Akiko Maehara, MDa,b,∗ (, )
- Mitsuaki Matsumura, BSb,
- Ziad A. Ali, MD, DPhila,b,
- Gary S. Mintz, MDb and
- Gregg W. Stone, MDa,b
- aCenter for Interventional Vascular Therapy, Division of Cardiology, New York-Presbyterian Hospital/Columbia University Medical Center, New York, New York
- bClinical Trials Center, Cardiovascular Research Foundation, New York, New York
- ↵∗Address for correspondence:
Dr. Akiko Maehara, Cardiovascular Research Foundation, 1700 Broadway, 9th Floor, New York, New York 10019.
Procedural guidance with intravascular ultrasound (IVUS) imaging improves the clinical outcomes of patients undergoing percutaneous coronary intervention (PCI) by: 1) informing the necessity for lesion preparation; 2) directing appropriate stent sizing to maximize the final stent area and minimize geographic miss; 3) selecting the optimal stent length to cover residual disease adjacent to the lesion, thus minimizing geographic miss; 4) guiding optimal stent expansion; 5) identifying acute complications (edge dissection, stent malapposition, tissue protrusion); and 6) clarifying the mechanism of late stent failure (stent thrombosis, neointimal hyperplasia, stent underexpansion or fracture, or neoatherosclerosis). Optical coherence tomography (OCT) provides similar information to IVUS (with some important differences), also potentially improving acute and long-term patient outcomes compared to angiography-guided PCI. The purpose of this review is to describe the similarities and differences between IVUS and OCT technologies, and to highlight the evidence supporting their utility to improve PCI outcomes.
Dr. Maehara has received consulting fees from Boston Scientific and OCT Medical Imaging Inc.; and research grants from Boston Scientific and Abbott Vascular. Dr. Ali holds institutional grant support from Abbott Vascular and Cardiovascular Systems Inc.; and has served as a consultant to Abbott Vascular, ACIST, Boston Scientific, and OCT Medical Imaging. Dr. Mintz has received consulting fees from ACIST, Boston Scientific, Volcano, and Infraredx; and research or fellowship support from Boston Scientific, Volcano, and Abbott Vascular. Dr. Stone has received consulting fees from Abbott Vascular. Mr. Matsumura has reported that he has no relationships relevant to the contents of this paper to disclose.
- Received May 23, 2017.
- Revision received August 11, 2017.
- Accepted September 28, 2017.
- 2017 American College of Cardiology Foundation
- Central Illustration
- Technical Differences Between OCT and IVUS
- Pre-Intervention Evaluation of Plaque Type Related to Acute Stent Outcomes
- Stent Sizing by IVUS
- Stent Sizing by OCT
- Post-Intervention Predictors of Clinical Outcomes
- IVUS-Guided PCI to Improve Outcomes
- OCT-Guided PCI to Improve Outcomes
- OCT-Guided Versus IVUS-Guided PCI
- Imaging Guidance for Bioresorbable Vascular Scaffold Implantation
- OCT Versus IVUS Findings and PCI Guidance in Cases of Stent Failure
- Summary and Conclusions