Abstract

JACC

Lots of interesting abstracts and cases were submitted for TCTAP 2022. Below are the accepted ones after a thorough review by our official reviewers. Don’t miss the opportunity to expand your knowledge and interact with authors as well as virtual participants by sharing your opinion in the comment section!

TCTAP A-052

Feasibility and Safety of Non-contrast Optical Coherence Tomography Imaging in Coronary Arteries

By Dong Oh Kang, Hyeong Soo Nam, Sun Won Kim, Hongki Yoo, Jin Won Kim

Presenter

Dong Oh Kang

Authors

Dong Oh Kang1, Hyeong Soo Nam2, Sun Won Kim1, Hongki Yoo2, Jin Won Kim1

Affiliation

Korea University Guro Hospital, Korea (Republic of)1, KAIST, Korea (Republic of)2
View Study Report
TCTAP A-052
Imaging: Intravascular

Feasibility and Safety of Non-contrast Optical Coherence Tomography Imaging in Coronary Arteries

Dong Oh Kang1, Hyeong Soo Nam2, Sun Won Kim1, Hongki Yoo2, Jin Won Kim1

Korea University Guro Hospital, Korea (Republic of)1, KAIST, Korea (Republic of)2

Background

Background and Objectives: Contemporary high-resolution intracoronary optical coherence tomography (OCT) requires injection of flushing media for image acquisition to avoid signal attenuation by red blood cells. There is a growing need for an alternative flushing media other than iodine contrast to reduce the risk of renal dysfunction. To address this issue, we investigated the safety and feasibility of pentastarch (hydroxyethyl starch) solution as a flushing media for OCT image acquisition and compared with the contrast media flushed images.

Methods

Materials and Methods: We prospectively enrolled 25 patients with 39 coronary lesions (26 stented lesions and 13 pre-stented or non-culprit lesions). Paired OCT images were obtained by manual injection of iodine contrast (average 12 mL), followed by pentastarch (average 15 mL). A total of 45 image runs were analyzed and each OCT pullback was assessed on a frame-by-frame basis by automated customized pixel-wise comparison algorithm. The number of clear image segments (CIS) and pre-specified quantitative measurements were compared between the paired OCT images.

Results

Results: Image quality as assessed by proportion of CIS showed no significant difference between the contrast media and pentastarch (98.4% vs. 97.6%; p=0.846). Pixel-wise blood flushing capability correlated well between the paired image segments (p<0.001; Figure). Quantitative measurements of minimal stent area (7.24 ± 0.85 vs. 7.19 ± 0.74; p=0.769), minimal lumen area (3.15 ± 0.54 vs. 3.11 ± 0.49; p=0.716) showed no significant difference between the paired OCT runs. There were no clinically relevant complications associated with OCT imaging with pentastarch administration such as anaphylactic reaction, life-threatening arrhythmia, heart failure, or acute renal deterioration.

Conclusion

Conclusions: Intracoronary OCT using pentastarch is safe and technically feasible without affecting the optical signal intensity and overall image quality. Non-contrast imaging with pentastarch significantly reduces the obligatory iodine contrast load, therefore, could be considered as a promising strategy in high-risk patients for renal impairment.

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