Optical coherence tomography for evaluation after coronary stent implantation

Optical coherence tomography (OCT) is being made available in more and more centres and has taken off from the realm of research to practical management of post PCI situations. OCT has a high resolution so that it can detect stent related issues at a superior level. Stent edge dissection, instent dissection, incomplete apposition of stents, tissue and thrombus protruding into the stent are some of the details visible by OCT. Tsunenari Soeda and colleagues [1] noted edge dissections in one fourth of their thousand odd stents and instent dissection in a surprising two thirds of cases. Incomplete stent apposition was noted in a third of cases. Low minimal stent area and irregular protrusions noted on OCT were the two factors which were predictive of clinical end points at one year. These end points were driven by target lesion revascularization.

Reference

  1. Soeda T et al. Incidence and Clinical Significance of Poststent Optical Coherence Tomography Findings: One-Year Follow-Up Study From a Multicenter Registry. Circulation. 2015 Sep 15;132(11):1020-9.