Coronary disease & ACSCohort study
Saline vs Contrast for Optical Coherence Tomography During Percutaneous Coronary Intervention
- prospective, multicenter, observational study
- paired contrast and heparinized saline optical coherence tomography (OCT) pullbacks during the same procedure
- 4 tertiary centers in India
- 2 blinded investigators
Authors' conclusion
Heparinized saline provides vessel measurements comparable to contrast media for frequency domain OCT without safety concerns. Saline flushing is a feasible alternative for OCT-guided PCI, particularly in patients at risk of contrast-induced nephropathy.
Study context
- Population
- Patients undergoing percutaneous coronary intervention (PCI)patients, 2072 matched pairs of OCT frames (in 259 paired OCT runs) analyzed
- Participants
- 166 patients
- Exposure
- heparinized saline and contrast as flushing media for coronary frequency domain optical coherence tomography (OCT) during percutaneous coronary intervention (PCI)
Main finding
As reported in the abstract
proximal reference diameter
P = 0.65
Observational data: associations, not effects.
Further findings
minimal lumen area · no significant difference
P = 0.85
minimum lumen diameter · no significant difference
P = 0.78
distal reference diameter · no significant difference
P = 0.83
Bland-Altman agreement
- good agreement without proportional bias
Interobserver reliability for vessel measurements
- Intraclass Correlation Coefficient (moderate to good)
- 0.69 to 0.79
Sensitivity analysis for clustering
- confirmed the robustness without proportional bias
Original publication
Saline vs Contrast for Optical Coherence Tomography During Percutaneous Coronary Intervention. JACC Adv. Published 20 March 2026. doi:10.1016/j.jacadv.2026.102679
Summarised from the published abstract; every number is checked against it