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EuroPCR 2016: Optimal imaging matches intravascular ultrasound for guiding PCI

OPINION study shows good clinical outcomes with optical frequency domain imaging

Using optimal frequency domain imaging (OFDI) to guide percutaneous coronary intervention (PCI) with second-generation drug eluting stents (DES) achieves equivalent clinical and angiographic outcomes to intravascular ultrasound (IVUS)-guided PCI at 12 months, show results from the OPINION study reported in a late-breaker session at EuroPCR 2016.

Non-Coronary Cardiac Intervention
Invasive Coronary Imaging and Hemodynamics
Cardiovascular Surgery
Peripheral Vascular Intervention


EMBARGOED: Tuesday 17 May 11:20 CEST

Paris, France – 17 May 2016: Using optimal frequency domain imaging (OFDI) to guide percutaneous coronary intervention (PCI) with second-generation drug eluting stents (DES) achieves equivalent clinical and angiographic outcomes to intravascular ultrasound (IVUS)-guided PCI at 12 months, show results from the OPINION study reported in a late-breaker session at EuroPCR 2016.

IVUS is an imaging modality used to assess lesion morphology during PCI and several studies have reported that IVUS guidance in PCI might be helpful to improve outcomes. OFDI is the most recently developed optical coherence tomography (OCT) technology that uses light rather than ultrasound to give high-resolution imaging.

“OPINION is the first study to compare clinical outcomes with OFDI and IVUS to assess lesion morphology during PCI with second-generation drug eluting stents,” explains study author Takashi Kubo, from Wakayama University, Wakayama, Japan.

The OPINION study researchers randomised 800 patients (mean age 68 years) scheduled for PCI using DES to either OFDI-guided PCI or IVUS-guided PCI at 42 centres in Japan. Patients underwent PCI using drug-eluting stents with resorbable polymer in de novo native coronary artery lesions. They were followed-up with angiography at eight months and the primary endpoint was target vessel failure assessing during clinical follow-up at 12 months.

Results of the non-inferiority study reported at EuroPCR 2016 showed a similarly low rate of target vessel revascularisation, a composite of cardiac death, target vessel-related MI and clinically driven target vessel revascularisation, at 12 months in patients undergoing OFDI-guided PCI (5.2%) as in those randomised to IVUS-guided PCI (4.9%).

“The clinical outcome in both OCT-guided PCI and IVUS-guided PCI was excellent,” reports Dr Kubo. He suggests the study results contribute to defining the clinical value of OCT guidance in PCI. “Our results might influence the next ESC guidelines, which currently give a class IIb recommendation for OCT. OCT use during PCI should have a class IIa recommendation,” he says.

Commenting on the findings Takashi Akasaka, Professor of Medicine at Wakayama Medical University, Wakayama, Japan, says, “There has previously been no direct comparative data for OCT/OFDI-guided PCI and IVUS-guided PCI. The OPINION study succeeded in demonstrating that OCT-guided PCI resulted in equivalent clinical and angiographic outcomes at 12 months to IVUS-guided PCI.”

Professor Akasaka considers the clinical outcome with both imaging strategies was very good, with a low rate of target vessel revascularisation. “Thus, the OPINION study may contribute to define the clinical value of the OCT guidance in PCI.” He agrees that the findings mean that OCT/OFDI-guided PCI should be given a class IIa recommendation.

ENDS

Notes to editor


Contact: Takashi Kubo, from Wakayama University, Wakayama, Japan;
EuroPCR 2016 session: Tuesday 17 May 11.20-12.20, Late-breaking trials, registries and innovations; Main Arena

Help for journalists to cover EuroPCR 2016

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What is EuroPCR?
EuroPCR, the official annual meeting of the European Association for Percutaneous Cardiovascular Interventions (EAPCI), a registered branch of the European Society of Cardiology, is the world-leading course in interventional cardiovascular medicine. PCR has established a distinctive format for educational activities in the field of cardiovascular interventions. Beyond its flagship course in Paris that gathers more than 12,000 participants every year, PCR organises annual courses in Singapore, London UK, Dubai EAU, Johannesburg RSA, Istanbul Turkey, Chengdu China and Tokyo Japan.
For further information on EuroPCR, AsiaPCR/SingLIVE, PCR London Valves, GulfPCR-GIM, AfricaPCR, PCR Istanbul Peripheral, PCR-CIT China Chengdu Valves, PCR Tokyo Valves & PCR, please contact: Anne-Sophie Lartigau at aslartigau@europa-organisation.com.

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