Abstract Summary
A randomized prospective trial comparing intra-procedural lumen expansion, calcium fracture identification, and post-stent malapposition detection using High-Resolution OCT versus Intravascular Ultrasound (IVUS) during severe calcified coronary plaque modification.
Article Description & Overview
EXECUTIVE SUMMARY:
Intracoronary imaging has revolutionized modern interventional cardiology by offering microscopic plaque characterization. Severe coronary calcification impedes adequate stent expansion and correlates strongly with early and late stent failure.
STUDY FINDINGS:
OCT demonstrated superior diagnostic sensitivity in detecting superficial micro-calcification fracture lines following intravascular lithotripsy (IVL) or rotational atherectomy (92% vs 64%, p<0.001). Minimum stent area (MSA) achieved at post-dilation was comparable between OCT and IVUS cohorts (8.4 mm² vs 8.2 mm²).
CLINICAL IMPLICATIONS:
Both OCT and IVUS significantly improve acute procedural success. OCT provides unmatched axial resolution for plaque preparation appraisal in severely calcified coronary arteries.
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