Document Detail


A multicentre evaluation of the safety of intracoronary optical coherence tomography.
MedLine Citation:
PMID:  19577988     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: Optical coherence tomography (OCT) is increasingly being applied to the coronary arteries. However, the risks associated with the imaging procedure are not yet well defined. The purpose of the present multicentre registry was to assess the acute complications associated with the clinical use of intra-coronary OCT in a large number of patients. METHODS AND RESULTS: Consecutive patients from six centres who had OCT examination were retrospectively included. All adverse events and complications, even if transient, were noted. Risks were categorised into: 1) self-limiting 2) major complications including major adverse cardiac events (MACE) and 3) mechanical device failure. A total of 468 patients underwent OCT examination for evaluation of: plaque (40.0%), percutaneous coronary intervention (28.2%) or follow-up stent tissue coverage (31.8%). OCT was performed using a non-occlusive flush technique in 45.3% with a mean contrast volume of 36.6+/-9.4ml. Transient chest pain and QRS widening/ST-depression/elevation were observed in 47.6% and 45.5% respectively. Major complications included five (1.1%) cases of ventricular fibrillation due to balloon occlusion and/or deep guide catheter intubation, 3 (0.6%) cases of air embolism and one case of vessel dissection (0.2%). There were no cases of coronary spasm or MACE during or within the 24 hour period following OCT examination. CONCLUSIONS: OCT is a specialised technique with a relatively steep learning curve. Major complications are uncommon and can be minimised with careful procedural planning and having an awareness of the potential contributory risks, especially deep guide catheter intubation during contrast flushing. Upcoming developments will make OCT more practical and less procedurally demanding, also potentially conserving contrast volume considerably.
Authors:
Peter Barlis; Nieves Gonzalo; Carlo Di Mario; Francesco Prati; Lutz Buellesfeld; Johannes Rieber; Miles C Dalby; Giuseppe Ferrante; Maria Cera; Eberhard Grube; Patrick W Serruys; Evelyn Regar
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology     Volume:  5     ISSN:  1774-024X     ISO Abbreviation:  -     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-07-06     Completed Date:  2009-07-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101251040     Medline TA:  EuroIntervention     Country:  France    
Other Details:
Languages:  eng     Pagination:  90-5     Citation Subset:  IM    
Affiliation:
Thoraxcenter, Erasmus Medical Centre, Rotterdam, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Transluminal, Percutaneous Coronary / instrumentation
Cardiovascular Diseases / etiology
Clinical Competence
Contrast Media / diagnostic use
Coronary Artery Disease / diagnosis*,  therapy
Coronary Vessels / pathology*
Europe
Humans
Male
Middle Aged
Predictive Value of Tests
Prosthesis Failure
Registries
Retrospective Studies
Risk Assessment
Stents
Tomography, Optical Coherence* / adverse effects
Treatment Outcome
Chemical
Reg. No./Substance:
0/Contrast Media

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