Optical coherence tomography to guide percutaneous coronary intervention of the left main coronary artery: the LEMON study.
Aged
Coronary Angiography
Coronary Artery Disease
/ diagnostic imaging
Coronary Vessels
/ diagnostic imaging
Female
Humans
Male
Percutaneous Coronary Intervention
/ adverse effects
Pilot Projects
Prospective Studies
Stents
Tomography, Optical Coherence
Treatment Outcome
Ultrasonography, Interventional
Journal
EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology
ISSN: 1969-6213
Titre abrégé: EuroIntervention
Pays: France
ID NLM: 101251040
Informations de publication
Date de publication:
11 Jun 2021
11 Jun 2021
Historique:
pubmed:
24
11
2020
medline:
16
6
2021
entrez:
23
11
2020
Statut:
epublish
Résumé
Intravascular ultrasound (IVUS)-guided PCI improves the prognosis of left main stem (LMS) PCI and is currently recommended by international guidelines. Although OCT resolution is greater than that of IVUS, this tool is not yet recommended in LMS angioplasty due to the absence of data. This pilot study aimed to analyse the feasibility, safety and impact of OCT-guided LMS PCI. This prospective, multicentre trial investigated whether patients might benefit from OCT-guided PCI for mid/distal LMS according to a pre-specified protocol. The primary endpoint was procedural success defined as follows: residual angiographic stenosis <50% + TIMI 3 flow in all branches + adequate OCT stent expansion (LEMON criteria). Seventy patients were included in the final analysis (median age: 72 [64-81] years, 73% male). The OCT pre-specified protocol was applied in all patients. The primary endpoint was achieved in 86% of subjects. Adequate stent expansion was observed in 86%, significant edge dissection in 30% and residual significant strut malapposition in 24% of the cases. OCT guidance modified the operators' strategy in 26% of the patients. The rate of one-year survival free from major adverse clinical events was 98.6% (97.2-100). This pilot study is the first to report the feasibility and performance of OCT-guided LMS PCI according to a pre-specified protocol.
Sections du résumé
BACKGROUND
BACKGROUND
Intravascular ultrasound (IVUS)-guided PCI improves the prognosis of left main stem (LMS) PCI and is currently recommended by international guidelines. Although OCT resolution is greater than that of IVUS, this tool is not yet recommended in LMS angioplasty due to the absence of data.
AIMS
OBJECTIVE
This pilot study aimed to analyse the feasibility, safety and impact of OCT-guided LMS PCI.
METHODS
METHODS
This prospective, multicentre trial investigated whether patients might benefit from OCT-guided PCI for mid/distal LMS according to a pre-specified protocol. The primary endpoint was procedural success defined as follows: residual angiographic stenosis <50% + TIMI 3 flow in all branches + adequate OCT stent expansion (LEMON criteria).
RESULTS
RESULTS
Seventy patients were included in the final analysis (median age: 72 [64-81] years, 73% male). The OCT pre-specified protocol was applied in all patients. The primary endpoint was achieved in 86% of subjects. Adequate stent expansion was observed in 86%, significant edge dissection in 30% and residual significant strut malapposition in 24% of the cases. OCT guidance modified the operators' strategy in 26% of the patients. The rate of one-year survival free from major adverse clinical events was 98.6% (97.2-100).
CONCLUSIONS
CONCLUSIONS
This pilot study is the first to report the feasibility and performance of OCT-guided LMS PCI according to a pre-specified protocol.
Identifiants
pubmed: 33226003
pii: EIJ-D-20-01121
doi: 10.4244/EIJ-D-20-01121
pmc: PMC9724912
pii:
doi:
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
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