A multicentre evaluation of the safety of intracoronary optical coherence tomography

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

Research output: Contribution to journalArticle

55 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)90-95
Number of pages6
JournalEuroIntervention
Volume5
Issue number1
Publication statusPublished - 2009

Fingerprint

Optical Coherence Tomography
Safety
Intubation
Catheters
Equipment Failure
Balloon Occlusion
Air Embolism
Learning Curve
Spasm
Ventricular Fibrillation
Percutaneous Coronary Intervention
Chest Pain
Stents
Registries
Dissection
Coronary Vessels

Keywords

  • Coronary arteries
  • Imaging
  • Optical coherence tomography
  • Safety

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Barlis, P., Gonzalo, N., Di Mario, C., Prati, F., Buellesfeld, L., Rieber, J., ... Regar, E. (2009). A multicentre evaluation of the safety of intracoronary optical coherence tomography. EuroIntervention, 5(1), 90-95.

A multicentre evaluation of the safety of intracoronary optical coherence tomography. / Barlis, Peter; Gonzalo, Nieves; Di Mario, Carlo; Prati, Francesco; Buellesfeld, Lutz; Rieber, Johannes; Dalby, Miles C.; Ferrante, Giuseppe; Cera, Maria; Grube, Eberhard; Serruys, Patrick W.; Regar, Evelyn.

In: EuroIntervention, Vol. 5, No. 1, 2009, p. 90-95.

Research output: Contribution to journalArticle

Barlis, P, Gonzalo, N, Di Mario, C, Prati, F, Buellesfeld, L, Rieber, J, Dalby, MC, Ferrante, G, Cera, M, Grube, E, Serruys, PW & Regar, E 2009, 'A multicentre evaluation of the safety of intracoronary optical coherence tomography', EuroIntervention, vol. 5, no. 1, pp. 90-95.
Barlis P, Gonzalo N, Di Mario C, Prati F, Buellesfeld L, Rieber J et al. A multicentre evaluation of the safety of intracoronary optical coherence tomography. EuroIntervention. 2009;5(1):90-95.
Barlis, Peter ; Gonzalo, Nieves ; Di Mario, Carlo ; Prati, Francesco ; Buellesfeld, Lutz ; Rieber, Johannes ; Dalby, Miles C. ; Ferrante, Giuseppe ; Cera, Maria ; Grube, Eberhard ; Serruys, Patrick W. ; Regar, Evelyn. / A multicentre evaluation of the safety of intracoronary optical coherence tomography. In: EuroIntervention. 2009 ; Vol. 5, No. 1. pp. 90-95.
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abstract = "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.",
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AU - Dalby, Miles C.

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