Clinical impact of optical coherence tomography (OCT)-derived suboptimal stent implantation parameters and definitions
Authors' conclusion
The clinical utility of OCT-guided PCI might depend on the metrics adopted to define suboptimal stent implantation. Uncovered disease at the stent border, stent edge dissection, and minimum stent area <4.5 mm2 were the strongest OCT associates of stent failure.
Study context
- Population
- Patients undergoing OCT-guided drug-eluting stent implantation in the all-comers CLI-OPCI registry
- Participants
- 1,020 patients
- Exposure
- Suboptimal vs optimal stent implantation by CLI-OPCI II, ILUMIEN-IV OPTIMAL PCI and FORZA OCT criteria
- Outcome
- Device-oriented CV events (DoCE)
- Follow-up
- Median 809 (quartiles 414-1376) days
Methodological detailsregistry-based, all-comers
- Registry-based
- All-comers
Main finding
As reported in the abstract
DoCE, by suboptimal stent implantation definition
CLI-OPCI II criteria
31.8%
Incidence of suboptimal stent implantation
ILUMIEN-IV OPTIMAL PCI criteria
58.1%
Incidence of suboptimal stent implantation
FORZA criteria
57.8%
Incidence of suboptimal stent implantation
Hazard ratio (95% CI)P value
CLI-OPCI II criteria
2.75(1.88–4.02)
P < 0.001ILUMIEN-IV OPTIMAL PCI criteria
1.79(1.18–2.71)
P = 0.006FORZA criteria
1.11(0.75–1.63)
P = 0.597Observational data: associations, not effects.
Further findings
OCT predictors of device-oriented cardiovascular events (DoCE) · long-term follow-up
| HR (CI) | P value | ||
|---|---|---|---|
| Stent edge disease with minimum lumen area <4.5 mm² | 8.17 (5.32–12.53) | P < 0.001 | |
| Stent edge dissection | 2.38 (1.33–4.27) | P = 0.004 | |
| Minimum stent area <4.5 mm² | 1.68 (1.13–2.51) | P = 0.011 | |
| 0.050.21520Hazard ratio (log scale) |
Original publication
Clinical impact of OCT-derived suboptimal stent implantation parameters and definitions. Eur Heart J Cardiovasc Imaging. Published 18 July 2023. doi:10.
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