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Efficacy of Optical Coherence Tomography-derived Morphometric Assessment in Predicting the Physiological Significance of Coronary Stenosis: Head-to-Head Comparison with Intravascular Ultrasound

2018; European Association of Percutaneous Cardiovascular Interventions; Volume: 13; Issue: 18 Linguagem: Inglês

10.4244/eij-d-17-00613

1969-6213

Eisuke Usui, Taishi Yonetsu, Yoshihisa Kanaji, Masahiro Hoshino, Masao Yamaguchi, Masahiro Hada, Rikuta Hamaya, Yoshinori Kanno, Tadashi Murai, Tetsumin Lee, Tsunekazu Kakuta,

Cerebrovascular and Carotid Artery Diseases

This study aimed to investigate the diagnostic efficacy of optical coherence tomography (OCT) in identifying functional significance via fractional flow reserve (FFR) compared with that of intravascular ultrasound (IVUS).We investigated 203 de novo intermediate coronary lesions of 186 patients who underwent frequency-domain OCT, IVUS and FFR measurements. Diagnostic efficacy of the minimal lumen area (MLA) obtained by OCT (OCT-MLA) and IVUS (IVUS-MLA) in predicting an FFR 1.39 mm2 and FFR <0.75) was 19% (22/113). Multivariate analysis showed that older age, non-left anterior descending artery and smaller angiographic reference diameter were independent predictors of false-positive results using the OCT-MLA criteria, whereas younger age and low left ventricular ejection fraction were independent predictors of false-negative results.Intravascular imaging is not interchangeable with FFR in clinical decision making. However, OCT may have superior efficacy to IVUS in detecting functional ischaemia. Discrepancies between OCT-MLA and FFR should be taken into account for OCT-guided decision making.