BOOM: A novel bifurcation stent technique using optical coherence tomography co-registration

Area of Science:

• Cardiovascular Medicine
• Interventional Cardiology
• Medical Imaging

Background:

• Bifurcation lesions are common in percutaneous coronary interventions (PCI), accounting for 20% of procedures.
• These lesions are linked to poorer long-term patient outcomes.
• Complex coronary anatomy, including bifurcations, necessitates improved PCI strategies.

Purpose of the Study:

• To evaluate the efficacy and safety of the Bifurcation and Ostial OCT Mapping (BOOM) technique.
• To assess the precision of stent placement in bifurcation lesions using OCT guidance.
• To determine the clinical outcomes following BOOM-guided PCI for ostial and bifurcation lesions.

Main Methods:

• Retrospective analysis of 48 patients undergoing OCT-guided bifurcation PCI.
• Application of the 'Bifurcation and Ostial OCT Mapping' (BOOM) technique.
• Primary endpoint: stent precision (distance from proximal strut to true ostium).
• Secondary endpoints: myocardial infarction, revascularization, and mortality at 6 and 12 months.

Main Results:

• 83.3% of patients had ostial lesions requiring treatment; the rest had true bifurcation disease.
• Most lesions (60.3%) were in the Left Anterior Descending (LAD) artery or its branches.
• Median stent geographic miss was 0.75 mm, indicating precise placement.
• Only one patient required target lesion revascularization by 6 months, with no further events by 12 months.

Conclusions:

• The BOOM technique is a safe and straightforward strategy for optimizing stent placement.
• BOOM enhances precision in treating ostial and bifurcation coronary lesions.
• This OCT-guided approach can improve PCI outcomes in complex cases.