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

▶
3d oct and bifurcations
SMART_READER_LITE
LIVE PREVIEW

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

Nov 23, 2022 275 likes •543 views

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,

slide-1
SLIDE 1

3D OCT and Bifurcations

OPTICS IN CARDIOLOGY ZÜRICH 2018

Niels Ramsing Holm Aarhus University Hospital, Skejby Denmark

slide-2
SLIDE 2

SKEJBY

PCI Research Aarhus University Hospital, Skejby ● Denmark Aarhus University Hospital niels.holm@clin.au.dk

Okamura et al EHJ 2010

3D OCT

slide-3
SLIDE 3

SKEJBY

PCI Research Aarhus University Hospital, Skejby ● Denmark Aarhus University Hospital niels.holm@clin.au.dk

3D OCT

Okamura et al. EuroIntervention 2018

slide-4
SLIDE 4

3D OCT

SKEJBY

PCI Research Aarhus University Hospital, Skejby ● Denmark Aarhus University Hospital niels.holm@clin.au.dk

slide-5
SLIDE 5

SKEJBY

PCI Research Aarhus University Hospital, Skejby ● Denmark Aarhus University Hospital niels.holm@clin.au.dk

3D OCT

slide-6
SLIDE 6

SKEJBY

PCI Research Aarhus University Hospital, Skejby ● Denmark Aarhus University Hospital niels.holm@clin.au.dk

Holm et al EuroIntvervention 2015

3D OCT

slide-7
SLIDE 7

Kang S et al. Circ Cardiovasc Interv. 2011;4:562-569

3D OCT

SKEJBY

PCI Research Aarhus University Hospital, Skejby ● Denmark Aarhus University Hospital niels.holm@clin.au.dk

slide-8
SLIDE 8

SKEJBY

PCI Research Aarhus University Hospital, Skejby ● Denmark Aarhus University Hospital niels.holm@clin.au.dk

2D OCT

Holm et al. In review

slide-9
SLIDE 9

SKEJBY

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

3D OCT

slide-10
SLIDE 10

3D OCT

CourtesyTroels Munck Nielsen, Aarhus University Hospital

SKEJBY

PCI Research Aarhus University Hospital, Skejby ● Denmark Aarhus University Hospital niels.holm@clin.au.dk

slide-11
SLIDE 11

QAngioOCTCutplane analysis, Medis medical imaging - CourtesyTroels Munck Nielsen, Aarhus University Hospital

3D OCT

SKEJBY

PCI Research Aarhus University Hospital, Skejby ● Denmark Aarhus University Hospital niels.holm@clin.au.dk

slide-12
SLIDE 12

Scientific evaluation

DESolve Baseline FANTOM baseline

3D OCT

SKEJBY

PCI Research Aarhus University Hospital, Skejby ● Denmark Aarhus University Hospital niels.holm@clin.au.dk

Holck et al. BIFSORB and FANTOM II Side Branch Study

slide-13
SLIDE 13

Ostial Side Branch Analysis

  • Stent Footprint
  • Ostial Side Branch Flow Area
  • Ostial Side Branch MLA

3D OCT

SKEJBY

PCI Research Aarhus University Hospital, Skejby ● Denmark Aarhus University Hospital niels.holm@clin.au.dk

Emil Nielsen Holck et al. FANTOM II Side Branch Study

slide-14
SLIDE 14

SKEJBY

PCI Research Aarhus University Hospital, Skejby ● Denmark Aarhus University Hospital niels.holm@clin.au.dk

Large footprint

Absorb BVS Xience DES

Bifurcation treatment using Absorb BVS is off-lable in USA.

3D OCT

Fox Maule, in review

slide-15
SLIDE 15

Ostial Side Branch Analysis

  • Stent Footprint
  • Ostial Side Branch Flow Area
  • Ostial Side Branch MLA

3D OCT

SKEJBY

PCI Research Aarhus University Hospital, Skejby ● Denmark Aarhus University Hospital niels.holm@clin.au.dk

Emil Nielsen Holck et al. FANTOM II Side Branch Study

slide-16
SLIDE 16

Bench model

  • Footprint: 46%
  • SB MLA: 4.9mm2
  • Flow area: 3.4mm2

3D OCT

SKEJBY

PCI Research Aarhus University Hospital, Skejby ● Denmark Aarhus University Hospital niels.holm@clin.au.dk

Emil Nielsen Holck et al. FANTOM II Side Branch Study

slide-17
SLIDE 17

SKEJBY

PCI Research Aarhus University Hospital, Skejby ● Denmark Aarhus University Hospital niels.holm@clin.au.dk

Baseline 1-month

Baseline =2.33±0.28mm Follow-up =3.06±0.48mm p =0.09

Desolve 150 is CE-marked but is not approved for use in USA

3D OCT

Emil Nielsen Holck et al. BIFSORB Pilot, in review

slide-18
SLIDE 18

SKEJBY

PCI Research Aarhus University Hospital, Skejby ● Denmark Aarhus University Hospital niels.holm@clin.au.dk

BIFSORB Pilot: Side branch flow area

Baseline = 1.39[0.89;3.64]mm2 Follow-up = 1.86[1.52;2.34]mm2

Emil Nielsen Holck et al. BIFSORB Pilot, in review

slide-19
SLIDE 19

3D OCT

Emil Nielsen Holck et al. FANTOM II Side Branch Study

SKEJBY

PCI Research Aarhus University Hospital, Skejby ● Denmark Aarhus University Hospital niels.holm@clin.au.dk

slide-20
SLIDE 20

SKEJBY

PCI Research Aarhus University Hospital, Skejby ● Denmark Aarhus University Hospital niels.holm@clin.au.dk

3D OCT

Emil Nielsen Holck et al. FANTOM II Side Branch Study

slide-21
SLIDE 21

SKEJBY

PCI Research Aarhus University Hospital, Skejby ● Denmark Aarhus University Hospital niels.holm@clin.au.dk Courtesy: Jo Simonsen

3D OCT

Fox Maule, in review

slide-22
SLIDE 22

SKEJBY

PCI Research Aarhus University Hospital, Skejby ● Denmark Aarhus University Hospital niels.holm@clin.au.dk Courtesy: Jo Simonsen

3D OCT

Fox Maule, in review

slide-23
SLIDE 23

3D OCT

SKEJBY

PCI Research Aarhus University Hospital, Skejby ● Denmark Aarhus University Hospital niels.holm@clin.au.dk

REVA Fantom is CE marked but is not approved for clinical use in USA

Omeed Neghabat OiC 2018

slide-24
SLIDE 24

SKEJBY

PCI Research Aarhus University Hospital, Skejby ● Denmark Aarhus University Hospital niels.holm@clin.au.dk

3D OCT Excellent tool, BUT More than 50% of 181 cases had artifacts resembling fracture

REVA Fantom is CE marked but is not approved for clinical use in USA

3D OCT

Omeed Neghabat OiC 2018

slide-25
SLIDE 25

SKEJBY

PCI Research Aarhus University Hospital, Skejby ● Denmark Aarhus University Hospital niels.holm@clin.au.dk

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

3D OCT