Trends in the Use of Lesion Evaluation Technology

Abstract

Introduction: Evaluation of coronary artery disease during cardiac catheterisation is an increasingly evolving field. Technology such as Intravascular Ultrasound (IVUS), Fractional Flow Reserve (FFR) and Optical Coherence Tomography (OCT) provide additional functional and anatomical information on which treatment is based. We sought to evaluate the change in usage of these modalities over time. Method: A five year retrospective data analysis between 1st January 2007 to 31st December 2011 of 17,149 patients who underwent coronary angiography at TPCH was undertaken and the incidence of lesion evaluation modalities was examined. We employed a nonparametric test for trend across ordered groups. Findings: 1140 patients received either IVUS, OCT or FFR evaluation. The percentage of patients who underwent one of the following lesion evaluation techniques increased over the five year period from 4.59% in 2007 to 9.13% in 2011 (p < 0.001). The proportion of patients receiving IVUS evaluation over the same period shifted from 64.67% to 30.12% (p < 0.001), FFR from 35.33% to 52.80% (p < 0.001) and OCT from 0.0% to 17.08% (p < 0.001). Conclusion: There is an increasing trend in the overall use of modalities for lesion evaluation. Whilst the overall IVUS usage remained similar across the five year period, the user friendly, higher resolution OCT technology has provided an additional evaluation tool within the intravascular imaging arena. FFR use has increased substantially and is now the main technology used for lesion evaluation.