Coronary disease & ACSSecondary analysis
Unintended Deformation of Stents During Bifurcation PCI
- Secondary analysis of the OCTOBER randomised trial
- prespecified analysis
Authors' conclusion
USD was associated with adverse procedural complications and cardiac events during follow-up when not identified and corrected. The predominant mechanisms were undetected abluminal rewiring and guide catheter collision. Left main bifurcation percutaneous coronary intervention was a particular risk with USD detected in 18.5% of cases.
Study context
- Population
- Optical coherence tomography (OCT)-guided complex bifurcation PCI589 OCT-guided cases
- Participants
- 30 vs 25
- Comparison
- Untreated unintended stent deformations (USD) vs Confirmed or possibly corrected USD
- Untreated USDn = 30
- Confirmed or possibly corrected USDn = 25
- Primary endpoint
- Incidence and mechanisms of unintended stent deformation (USD) identified by OCT
Primary result
As reported in the abstract
USD incidence and mechanisms
USD identified by core lab (55/589)
9.3%
Cause: accidental abluminal rewiring (24/55)
44%
Cause: guide catheter collision (22/55)
40%
Further findings
| Outcome | Untreated USD | Confirmed or possibly corrected USD |
|---|---|---|
| MACE · 2 years | 23.3% | 0 events |
USD in left main bifurcation PCI (subgroup)
- USD in left main bifurcation PCI
- 18.5%
Abluminal rewiring
- Total abluminal rewiring: 33 in 32 OCT-guided cases
- 5.4%
- Corrected by physicians (18 of 33)
- 54.5%
Original publication
Unintended Deformation of Stents During Bifurcation PCI. JACC Cardiovasc Interv. Published 13 May 2024. doi:10.1016/j.jcin.2024.03.013
Summarised from the published abstract; every number is checked against it