Kubo Takashi, Shinke Toshiro, Okamura Takayuki, Hibi Kiyoshi, Nakazawa Gaku, Morino Yoshihiro, Shite Junya, Fusazaki Tetsuya, Otake Hiromasa, Kozuma Ken, Akasaka Takashi
Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan.
Department of Internal Medicine, Division of Cardiovascular and Respiratory Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
J Cardiol. 2016 Nov;68(5):455-460. doi: 10.1016/j.jjcc.2015.11.007. Epub 2016 Jan 4.
Optical coherence tomography is becoming increasingly widespread as an adjunctive intravascular diagnostic technique in percutaneous coronary intervention (PCI), because of its ability to visualize coronary structures at high resolution. Several studies have reported that intravascular ultrasound (IVUS) guidance in PCI might be helpful to reduce subsequent stent thrombosis, restenosis, repeat revascularization, myocardial infarction, and cardiac death. The OPtical frequency domain imaging vs. INtravascular ultrasound in percutaneous coronary InterventiON (OPINION) trial is aimed at evaluating the impact of optical frequency domain imaging (OFDI) guidance in PCI on clinical outcomes compared with IVUS guidance.
The OPINION trial is a multicenter, prospective, randomized, controlled, open-label, parallel group, non-inferiority trial in Japan. The eligible patients are randomly assigned to receive either OFDI-guided PCI or IVUS-guided PCI. PCI is performed using the biolimus-eluting stent in accordance with a certain criteria of OFDI and IVUS for optimal stent deployment. All patients will undergo a follow-up angiography at 8 months. The primary endpoint is target vessel failure composed of cardiac death, myocardial infarction attributed to the target vessel, and clinically-driven target vessel revascularization at 12 months.
When completed, the OPINION trial will contribute to define the clinical value of the OFDI guidance in PCI.
光学相干断层扫描作为经皮冠状动脉介入治疗(PCI)中的一种辅助血管内诊断技术正日益普及,因为它能够高分辨率地显示冠状动脉结构。多项研究报告称,PCI中的血管内超声(IVUS)引导可能有助于减少后续的支架血栓形成、再狭窄、再次血管重建、心肌梗死和心源性死亡。光学频域成像与经皮冠状动脉介入治疗中的血管内超声(OPINION)试验旨在评估PCI中光学频域成像(OFDI)引导与IVUS引导相比对临床结局的影响。
OPINION试验是在日本进行的一项多中心、前瞻性、随机、对照、开放标签、平行组、非劣效性试验。符合条件的患者被随机分配接受OFDI引导的PCI或IVUS引导的PCI。根据OFDI和IVUS的特定标准使用生物可吸收涂层洗脱支架进行PCI,以实现最佳支架置入。所有患者将在8个月时接受随访血管造影。主要终点是12个月时由心源性死亡、靶血管所致心肌梗死和临床驱动的靶血管血运重建组成的靶血管失败。
OPINION试验完成后,将有助于确定OFDI引导在PCI中的临床价值。