Wire bias in coronary measurement using optical coherence tomography

Area of Science:

• Cardiovascular Imaging
• Medical Devices
• Interventional Cardiology

Background:

• Optical coherence tomography (OCT) is crucial for accurate coronary stent sizing.
• The influence of coronary artery tortuosity and guide wire characteristics on OCT accuracy remains unclear.

Purpose of the Study:

• To investigate the impact of guide wire properties on coronary diameter and length measurements using OCT in tortuous coronary arteries.
• To assess how guide wire stiffness and vessel curvature affect OCT-derived luminal dimensions.

Main Methods:

• OCT measurements of coronary diameters were taken in patients with tortuous arteries before and after supportive guide wire removal.
• A coronary model with varying lumen diameters was imaged using flexible and stiff guide wires under straight and curved (simulated tortuosity) conditions.

Main Results:

• In patients, lumen diameter decreased by ~3.2% after supportive guide wire removal.
• In the coronary model, tortuosity caused length underestimation (0-4.5% flexible, 0-12% stiff wire; P < 0.001) and diameter overestimation, particularly with stiffer wires.
• Diameter overestimation increased with vessel size and wire stiffness, and could be minimized by less eccentric catheter positioning.

Conclusions:

• OCT may underestimate coronary artery length and overestimate diameter in tortuous vessels.
• Increased guide wire stiffness exacerbates these inaccuracies.
• Consideration of these effects is vital for accurate coronary intervention planning in tortuous anatomy.