Abstract 11731: Efficacy of a New Generation Fast-Pullback, High-Frequency Intracoronary Optical Coherence Tomography Imaging on the Reduction of Contrast Medium in Clinical Practice

Abstract

Introduction: Intracoronary optical coherence tomography (OCT) is an imaging modality that uses near-infrared light to generate high-resolution images, and now plays an important role in research and clinical practice as it provides insights into vascular biology and diagnostic guidance for percutaneous intervention (PCI). An existing concern is that OCT imaging could increase the total amount of contrast media administered during the procedure, resulting in adverse outcomes such as impairment of renal function or worsening of heart failure in some patients. Aims: We sought to investigate whether a novel, fast-pullback, high-frequency OCT (HF-OCT) enables acquisitions with a reduced amount of contrast agents while retaining the same qualitative and quantitative lesion assessment to conventional OCT. Methods: This study is a single-center, prospective, observational study including 10 patients with stable coronary artery disease. A total of 28 individual coronary arteries were assessed by both fast-pullback HF-OCT and by conventional OCT. The fast-pullback, HF-OCT system consists of a 1.8-Fr Vis-Rx® Micro-Imaging Catheter and an HF-OCT Imaging console (Gentuity LLC, Sudbury, MA). Results: The contrast volume used in each OCT run for the HF-OCT system was significantly lower than for the conventional OCT system (5.0±0.0 vs. 7.8±0.7ml, P<0.001). No significant difference was found in the median value of the clear image length between the 2 OCT systems (74 mm [IQR; 63, 81], 74 mm [IQR; 71, 75], P=0.89). Fast-pullback HF-OCT showed comparable measurements to conventional OCT, including minimum lumen area (3.27±1.53 vs. 3.21±1.53 mm2, P=0.27), proximal reference area (7.03±2.28 vs. 7.03±2.34 mm2, P=0.96), and distal reference area (5.93±1.96 vs. 6.03±2.02 mm2, P=0.23). Qualitative OCT findings were comparable between the fast-pullback HF-OCT runs and conventional OCT with respect to identifying lipid-rich plaques, calcifications, layered plaques, macrophages, and cholesterol crystals. Conclusions: With the fast pullback function of a novel HF-OCT imaging system, we acquired OCT images using a significantly lower amount of contrast volume while retaining a comparable qualitative and quantitative lesion assessment to conventional OCT.