This study presented at the ESC and simultaneously published in Circulation, is the first randomized controlled study to support the use of optical coherence tomography (OCT) in the context of ACS patients.
The study randomized 240 patients undergoing non ST elevation acute coronary syndrome to OCT guided PCI (before and after PCI) vs. conventional angiography guided PCI.
OCT changed the strategy in nearly half of randomized patients to this group. I was able to detect thrombi prior PCI that had not been detected by conventional angiography –this explains the more frequent use of IIBIIIA inhibitors in this group- and could also detect malapposition, underexpansion and post PCI edge dissection leading to post dilation and additional stenting.
Globally, OCT lead to some kind of optimization in 50% of patients, vs. 22% lead by conventional angiography (p< 0.0001). Post procedural fractional flow reserve (FFR) was significantly higher in the group receiving OCT (0.94 ± 0.04 vs 0.92 ± 0.05; p= 0.005).
Original Title: Optical coherence tomography to optimize results of percutaneous coronary intervention in patients with non-ST-elevation acute coronary syndromes. Results of the multicenter, randomized DOCTORS (Does Optimal Coherence Tomography Optimize Results of Stenting) study.
Presenter: Nicolas Meneveau.
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