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3D OCT and Bifurcations OPTICS IN CARDIOLOGY ZRICH 2018 Niels - PowerPoint PPT Presentation

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3D OCT and Bifurcations OPTICS IN CARDIOLOGY ZRICH 2018 Niels Ramsing Holm Aarhus University Hospital, Skejby Denmark 3D OCT Okamura et al EHJ 2010 PCI Research Aarhus University Hospital niels.holm@clin.au.dk Aarhus University Hospital,

  1. 3D OCT and Bifurcations OPTICS IN CARDIOLOGY ZÜRICH 2018 Niels Ramsing Holm Aarhus University Hospital, Skejby Denmark

  2. 3D OCT Okamura et al EHJ 2010 PCI Research Aarhus University Hospital niels.holm@clin.au.dk Aarhus University Hospital, Skejby ● Denmark SKEJBY

  3. 3D OCT Okamura et al. EuroIntervention 2018 PCI Research Aarhus University Hospital niels.holm@clin.au.dk Aarhus University Hospital, Skejby ● Denmark SKEJBY

  4. 3D OCT PCI Research Aarhus University Hospital niels.holm@clin.au.dk Aarhus University Hospital, Skejby ● Denmark SKEJBY

  5. 3D OCT PCI Research Aarhus University Hospital niels.holm@clin.au.dk Aarhus University Hospital, Skejby ● Denmark SKEJBY

  6. 3D OCT Holm et al EuroIntvervention 2015 PCI Research Aarhus University Hospital niels.holm@clin.au.dk Aarhus University Hospital, Skejby ● Denmark SKEJBY

  7. 3D OCT Kang S et al. Circ Cardiovasc Interv . 2011;4:562-569 PCI Research Aarhus University Hospital niels.holm@clin.au.dk Aarhus University Hospital, Skejby ● Denmark SKEJBY

  8. 2D OCT Holm et al. In review PCI Research Aarhus University Hospital niels.holm@clin.au.dk Aarhus University Hospital, Skejby ● Denmark SKEJBY

  9. 3D OCT DOCTOR LM Troels Munck Nielsen, Aarhus University Hospital PCI Research Aarhus University Hospital niels.holm@clin.au.dk Aarhus University Hospital, Skejby ● Denmark SKEJBY

  10. 3D OCT CourtesyTroels Munck Nielsen, Aarhus University Hospital PCI Research Aarhus University Hospital niels.holm@clin.au.dk Aarhus University Hospital, Skejby ● Denmark SKEJBY

  11. 3D OCT QAngioOCTCutplane analysis, Medis medical imaging - CourtesyTroels Munck Nielsen, Aarhus University Hospital PCI Research Aarhus University Hospital niels.holm@clin.au.dk Aarhus University Hospital, Skejby ● Denmark SKEJBY

  12. 3D OCT Scientific evaluation DESolve Baseline FANTOM baseline Holck et al. BIFSORB and FANTOM II Side Branch Study PCI Research Aarhus University Hospital niels.holm@clin.au.dk Aarhus University Hospital, Skejby ● Denmark SKEJBY

  13. 3D OCT Ostial Side Branch Analysis • Stent Footprint • Ostial Side Branch Flow Area • Ostial Side Branch MLA Emil Nielsen Holck et al. FANTOM II Side Branch Study PCI Research Aarhus University Hospital niels.holm@clin.au.dk Aarhus University Hospital, Skejby ● Denmark SKEJBY

  14. 3D OCT Large footprint Absorb BVS Xience DES Fox Maule, in review Bifurcation treatment using Absorb BVS is off-lable in USA. PCI Research Aarhus University Hospital niels.holm@clin.au.dk Aarhus University Hospital, Skejby ● Denmark SKEJBY

  15. 3D OCT Ostial Side Branch Analysis • Stent Footprint • Ostial Side Branch Flow Area • Ostial Side Branch MLA Emil Nielsen Holck et al. FANTOM II Side Branch Study PCI Research Aarhus University Hospital niels.holm@clin.au.dk Aarhus University Hospital, Skejby ● Denmark SKEJBY

  16. 3D OCT Bench model • Footprint: 46% • SB MLA: 4.9mm 2 • Flow area: 3.4mm 2 Emil Nielsen Holck et al. FANTOM II Side Branch Study PCI Research Aarhus University Hospital niels.holm@clin.au.dk Aarhus University Hospital, Skejby ● Denmark SKEJBY

  17. 3D OCT Desolve 150 is CE-marked but is not approved for use in USA Baseline 1-month Baseline =2.33 ± 0.28mm Follow-up =3.06 ± 0.48mm p =0.09 Emil Nielsen Holck et al. BIFSORB Pilot, in review PCI Research Aarhus University Hospital niels.holm@clin.au.dk Aarhus University Hospital, Skejby ● Denmark SKEJBY

  18. BIFSORB Pilot: Side branch flow area Baseline = 1.39[0.89;3.64]mm 2 Follow-up = 1.86[1.52;2.34]mm 2 Emil Nielsen Holck et al. BIFSORB Pilot, in review PCI Research Aarhus University Hospital niels.holm@clin.au.dk Aarhus University Hospital, Skejby ● Denmark SKEJBY

  19. 3D OCT Emil Nielsen Holck et al. FANTOM II Side Branch Study PCI Research Aarhus University Hospital niels.holm@clin.au.dk Aarhus University Hospital, Skejby ● Denmark SKEJBY

  20. 3D OCT Emil Nielsen Holck et al. FANTOM II Side Branch Study PCI Research Aarhus University Hospital niels.holm@clin.au.dk Aarhus University Hospital, Skejby ● Denmark SKEJBY

  21. 3D OCT Courtesy: Jo Simonsen Fox Maule, in review PCI Research Aarhus University Hospital niels.holm@clin.au.dk Aarhus University Hospital, Skejby ● Denmark SKEJBY

  22. 3D OCT Courtesy: Jo Simonsen Fox Maule, in review PCI Research Aarhus University Hospital niels.holm@clin.au.dk Aarhus University Hospital, Skejby ● Denmark SKEJBY

  23. 3D OCT Omeed Neghabat OiC 2018 REVA Fantom is CE marked but is not approved for clinical use in USA PCI Research Aarhus University Hospital niels.holm@clin.au.dk Aarhus University Hospital, Skejby ● Denmark SKEJBY

  24. 3D OCT 3D OCT Excellent tool, BUT More than 50% of 181 cases had artifacts resembling fracture Omeed Neghabat OiC 2018 REVA Fantom is CE marked but is not approved for clinical use in USA PCI Research Aarhus University Hospital niels.holm@clin.au.dk Aarhus University Hospital, Skejby ● Denmark SKEJBY

  25. 3D OCT Conclusion • 3D OCT aids the spatial perception of bifurcation anatomy • 3D OCT may be used for evaluate guide wire positions whenever relevant • Detection of stent fracture by 3D OCT is promising but frequent artifacts is a concern • Area measurement by 3D adjusted cross sections should be made available in clinical OCT systems Thank you PCI Research Aarhus University Hospital niels.holm@clin.au.dk Aarhus University Hospital, Skejby ● Denmark SKEJBY

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