Ischaemic Heart Disease Clinical Trial
Official title:
Impact of Real-time Angiographic Co-registered OCT on PCI Results - the Randomized OPTICO-integration II Study
Intracoronary optical coherence tomography (OCT) imaging allows for high-resolution characterization of coronary lesions. Difficulties in matching cross-sectional OCT-images with angiographic lesion localization, however, may limit its clinical utilization. The investigators sought to prospectively assess the impact of a novel system of real-time OCT-coregistration with angiography (ACR) compared to OCT alone and to the clinical standard proceeding (angiographic guided-PCI) all used for coronary lesion evaluation before percutaneous coronary interventions (PCI). The investigators hypothesize that the use of ACR will lead to less incidence of insufficient covered coronary lesions (geographical mismatch) and/or a less rate of edge dissections after PCI (combined primary study endpoint)
In this randomized blinded pilot-study the effect of pre-PCI planning by
angiographic-co-registered OCT (ACR) compared to OCT or angiographic evaluation alone with
respect to the entire result after PCI will be investigated. A special focus (primary
endpoint) will be on the incidence of geographical mismatch (GM) and/or major edge
dissections. Eligible patients will be randomized in three groups.
Group 1 Pre-PCI-OCT: Patients underwent OCT-imaging before PCI. Lesion assessment, selection
of PCI landing zone as well as stent selection will be performed by investigators based on
OCT findings.
Group 2: Pre-PCI-ACR: Patients underwent ACR-imaging before PCI. Lesion assessment, selection
of PCI landing zone as well as stent selection will be performed by investigators based on
ACR-findings.
Group 3:OCT-Blinded/Angiographic guided PCI: Lesion assessment, selection of PCI landing zone
as well as stent selection will be performed by investigators only based on angiographic
lesion evaluation (standard care).
For outcome analysis all study groups underwent post-PCI-OCT imaging as soon as investigators
assume angiographic justiciable PCI-results (TIMI III, no residual stenosis > 50%; no
angiographic definable or suspicious edge dissections, angiographic acceptable stent
expansion without evidence for malapposition). OCT imaging analysis will be performed within
a OCT core-lab by two investigators blinded for the randomization group.
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