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Volume 8 Issue 1 (January, 2020)

Original Articles

Assessment of Coronary Bifurcation Stenting using Optical Coherence Tomography
Sanjay Kumar Singh

Background: Bifurcation Percutaneous coronary intervention is technically challenging despite improvement in techniques and devices. Side-branch occlusion occurs in about 10% of bifurcation percutaneous coronary interventions cases. We evaluated the use of OCT for PCI optimization in bifurcation lesions, using provisional one-stent and elective two-stent strategies. Methods: This prospective, observational study included 10 patients with 12 in coronary bifurcation lesions undergoing PCI (one-stent or two-stent strategy) who were evaluated with OCT. After stent placement, OCT was used to assess acute stent malapposition, under expansion, stent edge dissection, tissue protrusion, and micro thrombi. Results: The overall incidence of stent malapposition was 58.33%. It was more common with two-stent strategy (80%) compared to one-stent strategy (33.33%). The incidence of malapposition was highest in side-branch and least in distal segment of main vessel. Stent under expansion was seen in 25% of cases. Stent edge dissections, micro thrombi, tissue prolapse were noted in 16.66% of cases. OCT findings led to additional interventional steps in 33.33% of cases. Conclusion: OCT can be used to comprehensively assess procedural results after bifurcation stenting. The incidence of acute stent malapposition is high after stenting at bifurcation sites and is more common when the two-stent techniques are used. Key words: Optical Coherence Tomography, Percutaneous coronary intervention, stent.

 
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