Feasibility and safety of frequency-domain optical coherence tomography for coronary artery evaluation: a...

We assessed the feasibility and safety of frequency-domain optical coherence tomography (FD-OCT) in a variety of indications. We conducted a retrospective analysis of all FD-OCT examinations performed for research and clinical indications, including stable angina, acute coronary syndromes, diagnostic procedures and percutaneous coronary intervention (PCI), at the Satakunta Central Hospital (Pori, Finland) between August 12th 2009 and February 9th 2011. All pullbacks were screened for image quality. Data on complications and clinical implications of examinations was obtained from patient records. The mean age of the patients was 65.9 ± 10.9 years (81.7% males). A total of 230 examinations were performed on 210 patients; 523 pullbacks were eventually attempted (519 successful). On average, 2.3 ± 1.1 pullbacks were performed, and 1.1 ± 0.4 vessels were scanned per examination. PCI was performed in 44.3% of examinations. Radial access was used in 70.3% of cases. Examination was successful in 202 (87.8%) examinations. One patient died of heart failure later after PCI for acute myocardial infarction. No cases of major bleeding, myocardial infarction, contrast-induced nephropathy, or pericardial tamponade were encountered. Chest pain occurred in 10.9% of examinations, minor bleeding in 4.8%, and myocardial ischemia in 2.6%. Femoral access was associated with fewer blood and decentration artefacts and a trend towards better image quality when compared to radial access, with no difference in complications. After the first 50 examinations, there appeared to be fewer artefacts in the subsequent examinations. The current study demonstrated that FD-OCT is feasible, with infrequent complications.