Coronary disease & ACSSecondary analysis
Optical coherence tomography versus angiographic guidance in true unprotected left main bifurcation disease: an OCTOBER substudy
- OCTOBER substudy
- randomised to either optical coherence tomography (OCT) or angiographic guidance in the OCTOBER Trial
Authors' conclusion
OCT-guided PCI in true LMCA bifurcation lesions was clinically feasible, but visibility of the LMCA ostium was limited by short pullbacks, insufficient clearance, or guide catheter shadowing. OCT guidance was associated with a non-significant reduction in MACE, consistent with the effect estimate in the main trial.
Study context
- Population
- Patients with true unprotected left main coronary artery (LMCA) bifurcation lesions undergoing percutaneous coronary intervention (PCI)patients included · OCT 111 · angiography 116
- Participants
- 227 patients
- Comparison
- OCT guidance compared with angiographic guidance in PCI of true LMCA bifurcation lesions
- OCTn = 111
- angiographyn = 116reference
Primary result
As reported in the abstract
Major adverse cardiac events (MACE):
- Cardiac death
- Any myocardial infarction
- Target lesion revascularisation
Hazard ratio
0.78
95% CI 0.39–1.51
By group
OCT vs angiography
hazard ratio 0.78 (95% CI 0.39–1.51)
Further findings
Feasibility of OCT guidance (successful pullbacks, as per protocol)
- Pre-stenting pullback performed
- 98%
- Final pullback performed
- 96%
Analysability of the proximal LMCA stent edge
- Proximal LMCA stent edge analysable
- 43%
- Not analysable
- 57%
- Of the remaining 57% (not analysable), limited by insufficient image quality
- 5%
Original publication
Optical coherence tomography versus angiographic guidance in true unprotected left main bifurcation disease: an OCTOBER substudy. EuroIntervention. Published 15 May 2026. doi:10.4244/eij-d-25-01337
Summarised from the published abstract; every number is checked against it