Januszek Rafał, Siłka Wojciech, Sabatowski Karol, Malinowski Krzysztof Piotr, Heba Grzegorz, Surowiec Sławomir, Chyrchel Michał, Rzeszutko Łukasz, Bryniarski Leszek, Surdacki Andrzej, Bartuś Krzysztof, Bartuś Stanisław
Department of Cardiology and Cardiovascular Interventions, University Hospital, 30-688 Kraków, Poland.
Students' Scientific Group, the Second Department of Cardiology, Jagiellonian University Medical College, 2 Jakubowskiego, 31-034 Kraków, Poland.
J Cardiovasc Dev Dis. 2022 Jul 6;9(7):218. doi: 10.3390/jcdd9070218.
(1) Introduction: Optical coherence tomography (OCT) intravascular imaging facilitates percutaneous coronary intervention (PCI). Software for OCT is being constantly improved, including the latest version Ultreon™ 1.0 Software (U) (Abbott Vascular, Santa Clara, CA, USA). In the current analysis, we aim to compare processing results, procedural indices as well as clinical outcomes in patients treated via PCI. This was conducted using earlier generation OCT imaging software versions (non-U) and the newest available one on the market (U). (2) Methods: The study comprised 95 subsequent and not selected patients (55 processed with U and 40 non-U). The non-U processings were transferred for evaluation by U software, while the comparison of OCT parameters, selected clinical and procedural indices was performed between groups. We further assessed clinical outcomes during the follow-up period, i.e., major adverse cardiovascular events (MACE) and predictors of stent expansion. (3) Results: We did not detect any differences in general features between either of the assessed groups at baseline. Non-U software was more often used for bare-metal stenting ( = 0.004), while PCIs in the U group demanded a greater number of stents ( = 0.03). The distal reference of external elastic lamina (EEL) diameter was greater in the non-U group ( = 0.02) with no concurrent differences in minimal ( = 0.27) and maximal ( = 0.31) stent diameter. It was also observed that MACE was more frequently observed in the non-U group ( = 0.01). Neither univariable (estimate: 0.407, 95%CI: (-3.182) - 3.998, = 0.82) nor multivariable (estimate: 2.29, 95%CI: (-4.207) - 8.788, = 0.5) analyses demonstrated a relationship between the type of software and stent expansion. (4) Conclusions: Improvement in the software for image acquisition and processing of OCT is not related to stent expansion. The EEL diameter is preferably used to select the distal stent diameter in newer software.
(1) 引言：光学相干断层扫描（OCT）血管内成像有助于经皮冠状动脉介入治疗（PCI）。OCT软件在不断改进，包括最新版本的Ultreon™ 1.0软件（U）（美国加利福尼亚州圣克拉拉市雅培血管公司）。在本次分析中，我们旨在比较通过PCI治疗的患者的处理结果、手术指标以及临床结局。这是使用早期版本的OCT成像软件（非U）和市场上最新的软件（U）进行的。(2) 方法：该研究纳入了95例连续且未经过筛选的患者（55例使用U软件处理，40例使用非U软件处理）。非U软件处理的结果被转用U软件进行评估，同时在两组之间对OCT参数、选定的临床和手术指标进行比较。我们进一步评估了随访期间的临床结局，即主要不良心血管事件（MACE）和支架扩张的预测因素。(3) 结果：在基线时，我们未发现任何一组评估对象的一般特征存在差异。非U软件更常用于裸金属支架置入（P = 0.004），而U组的PCI需要更多数量的支架（P = 0.03）。非U组的外部弹性膜（EEL）直径的远端参考值更大（P = 0.02），而最小（P = 0.27）和最大（P = 0.31）支架直径没有同时存在差异。还观察到非U组中MACE更频繁出现（P = 0.01）。单变量分析（估计值：0.407，95%置信区间：(-3.182) - 3.998，P = 0.82）和多变量分析（估计值：2.29，95%置信区间：(-4.207) - 8.788，P = 0.5）均未显示软件类型与支架扩张之间存在关联。(4) 结论：OCT图像采集和处理软件的改进与支架扩张无关。在较新的软件中，EEL直径最好用于选择远端支架直径。
