Optical coherence tomography-guided stent optimization for complex coronary lesions: the OCCUPI trial
Authors' conclusion
The current study identifies long lesions or small-vessel disease as the determinants of stent optimization following OCT guidance, with the achievement of stent optimization significantly associated with improved clinical outcomes.
Study context
- Population
- Patients with complex coronary lesions who underwent optical coherence tomography (OCT)-guided percutaneous coronary intervention (PCI) with post-stenting OCT evaluationOCT-guided PCI
- Participants
- 773 patients
- Comparison
- OCT Optimization vs OCT Sub-Optimization after OCT-guided PCI
- OCT Optimizationn = 549
- OCT Sub-Optimizationn = 224reference
- Primary endpoint
- Cardiac death, MI, stent thrombosis or ischemia-driven target vessel revascularization
- Follow-up
- One year
Methodological detailsas-treated population
- As-treated population
Primary result
As reported in the abstract
Hazard ratio (95% CI)P value
OCT Optimization vs OCT Sub-Optimization
0.30(0.16–0.58)
P < 0.001OCT Optimization vs Angiography guidance
0.38(0.22–0.66)
P < 0.001Further findings
Predictors of OCT Sub-Optimization (multivariable)
- Long lesions and small-vessel disease were significant independent predictors
Components of OCCUPI-OCT criteria (stent expansion, apposition, absence of major edge dissection)
- Each acceptable component significantly associated with favourable outcomes
- all P < .001
Original publication
Optical coherence tomography-guided stent optimization for complex coronary lesions: the OCCUPI trial. Eur Heart J. Published 19 November 2025. doi:10.
Summarised from the published abstract; every number is checked against it