Researchers conducted a randomized study that included a total of 1233 patients who underwent percutaneous transluminal coronary angioplasty (PTCA) guided by optical coherence tomography (OCT) and 1254 patients who underwent the same procedure but were guided by angiography. The latter had complex lesions.
The initial groups were similar. The average age was 65 years, most participants were men, and 42% of all subjects had diabetes.
Patients who underwent OCT-guided PTCA showed a larger minimum luminal area, 5.72 ± 2.04 mm2, compared with patients who underwent angiography-guided procedures, who had a minimum luminal area 5.36 ± 1.87 mm2 (mean difference, 0.36 mm2; 95% confidence interval [CI], 0.21 to 0.51; P < 0.001).
At 2 years of follow-up, there were no differences in target lesion failure (TLF). The rate of TLF was 7.4% in the OCT-guided group and 8.2% in the angiography-guided group (hazard ratio, 0.90; 95% CI, 0.67 to 1.19; p-value = 0.45).
The authors concluded that patients who underwent OCT-guided PTCA showed an increase in minimum luminal area, but this improvement did not translate into a significant difference in TLF at the 2-year follow-up.
Dr. Carlos Fava.
Member of the editorial board of SOLACI.org.
Source: Presented by Ziad Ali during the ESC 2023 Sessions
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