Safety and feasibility of a new non-occlusive technique for facilitated intracoronary optical coherence tomography (OCT) acquisition in various clinical and anatomical scenarios

Abstract

To facilitate OCT images acquisition we developed a novel, simplified, non-occlusive technique based on manual infusion of a viscous isosmolar solution. The aims of the present study was to address the safety and efficacy of non-occlusive OCT images acquisition modality in a patient population with complex coronary lesions, and in various clinical scenarios. OCT assessment was performed with the LightLab OCT Imagewire in 64 patients. The imaging acquisition technique was aimed at target lesion and proximal and distal reference segments. OCT images were deemed of good quality if they allowed both an accurate measurement of luminal area and a qualitative classification of the superficial plaque components.In 60 patients (93.7%), the procedure was successful. The mean images acquisition time was 5.3+/-1.4 minutes. No major complications such as death, myocardial infarction or major arrhythmias were recorded. The average length of imaged segments was 28.6+/-6.1 mm and 95.1% of the imaged segments were deemed of sufficient quality to evaluate luminal area and plaque morphology (intra-observer and inter-observer variability 0.71, p<0.0001 and 0.68, p<0.0001 respectively).Conclusions. The non-occlusive modality of OCT image acquisition is safe and effective, and promises to simplify the complex current occlusive technique, leading to a marked reduction of procedural time.