Optical Coherence Tomography–guided versus IntraVascular UltraSound–guided percutaneous coronary intervention - OCTIVUS

Aug 27, 2023
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Author/Summarized by Author:
Anthony A. Bavry, MD, MPH, FACC
Trial Sponsor:
CardioVascular Research Foundation, Abbott Vascular, Medtronic.
Date Presented:
08/27/2023
Date Published:
08/27/2023
Original Posted Date:
08/27/2023
References

Contribution To Literature:

The OCTIVUS trial showed that OCT-guided PCI is noninferior to IVUS-guided PCI.

Description:

The goal of the trial was to evaluate optical coherence tomography (OCT)-guided percutaneous coronary intervention (PCI) compared with intravascular ultrasound (IVUS)-guided PCI among patients undergoing coronary revascularization.

Study Design

  • Randomized
  • Parallel

Patients undergoing coronary revascularization were randomized to OCT-guided PCI (n = 1,005) vs. IVUS-guided PCI (n = 1,003).

  • Total number of enrollees: 2,008
  • Duration of follow-up: 1 year
  • Mean patient age: 64 years
  • Percentage female: 21%
  • Percentage with diabetes: 32%

Inclusion criteria:

  • Patients ≥19 years of age undergoing PCI

Exclusion criteria:

  • ST-segment elevation myocardial infarction
  • Renal dysfunction
  • Cardiogenic shock or decompensated heart failure
  • Limited life expectancy

Other salient features/characteristics:

  • Diffuse long lesion, 57%
  • Total stent length, 47 mm

Principal Findings:

The primary outcome, cardiovascular death, target vessel myocardial infarction, or ischemia-driven target vessel revascularization, occurred in 2.5% of the OCT group vs. 3.1% of the IVUS group (p for noninferiority < 0.001).

Secondary outcomes:

  • Target vessel myocardial infarction: 0.9% of the OCT group vs. 1.4% of the IVUS group
  • Repeat revascularization: 1.6% of the OCT group vs. 1.9% of the IVUS group

Interpretation:

Among patients undergoing coronary revascularization, OCT-guided PCI was noninferior to IVUS-guided PCI. Intravascular imaging is a useful tool to optimize stent implantation. The results of this study found that OCT resulted in similar outcomes compared with IVUS.

References:

Kang DY, Ahn JM, Yun SC, et al., on behalf of the OCTIVUS Investigators. Optical Coherence Tomography-Guided or Intravascular Ultrasound Guided Percutaneous Coronary Intervention: The OCTIVUS Randomized Clinical Trial. Circulation 2023;Aug 27:[Epub ahead of print].

Presented by Dr. Duk-Woo Park at the European Society of Cardiology Congress, Amsterdam, Netherlands, August 27, 2023.

Clinical Topics: Cardiac Surgery, Invasive Cardiovascular Angiography and Intervention, Noninvasive Imaging, Atherosclerotic Disease (CAD/PAD), Aortic Surgery, Interventions and Coronary Artery Disease, Interventions and Imaging, Angiography, Echocardiography/Ultrasound, Nuclear Imaging

Keywords: Computed Tomography, Coronary Angiography, Coronary Artery Disease, Diagnostic Imaging, ESC Congress, ESC23, Myocardial Infarction, Myocardial Revascularization, Percutaneous Coronary Intervention, Stents, Tomography, Optical Coherence, Ultrasonography


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