A proof-of-concept experiment that integrates coronary CT scans and intracoronary imaging technologies within navigation systems could open the door to PCI with no contrast media or X-rays in humans, according to research presented at TCT 2021 and simultaneously published in JACC: Basic to Translational Science.

Jean-François Dorval, MD, and colleagues note that contrast media and x-rays used in vascular interventional procedures have been linked to health hazards for patients and medical teams. Their proof-of-concept study in healthy Yorkshire pigs (median weight 36kg; range, 33-40 kg) tested the use of modified optical coherence tomography and an impedance-sensitive navigation system to successfully deliver and implant stents in coronary and carotid arteries with appropriate sizing and wall apposition without using additional contrast and x-ray beyond what was necessary for the computed tomographic angiography and anatomical mapping.

Overall, the system achieved an accuracy of 90% and a precision of 1.4 mm, with modified stents successfully implanted in 9/11 (82%) of attempted targets (7 carotid and 4 coronary arteries). Dorval, et al., say these findings have important clinical implications, especially “given the growing role played by non-invasive imaging modalities in the primary stratification of patients with stable ischemic heart disease and symptomatic cerebrovascular disease and the increasing emphasis on avoidance of the hazards related to x-ray and contrast medium use.” They add that, “such a disruptive approach has the potential to leverage non-invasive imaging already being used in patient stratification, to alter fundamentally the way that vascular interventions are performed in the future.”

Clinical Topics: Cardiovascular Care Team, Invasive Cardiovascular Angiography and Intervention, Noninvasive Imaging, Vascular Medicine, Interventions and Imaging, Interventions and Vascular Medicine, Angiography, Computed Tomography, Nuclear Imaging

Keywords: Transcatheter Cardiovascular Therapeutics, TCT21, Cerebrovascular Disorders, Carotid Arteries, Myocardial Ischemia, Stents, Computed Tomography Angiography, Radiography, Angiography, Tomography, X-Ray Computed, Percutaneous Coronary Intervention, Electric Impedance, Tomography, Optical Coherence, Contrast Media, Proof of Concept Study, X-Rays, Coronary Vessels

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