SỰ THAY ĐỔI CHIẾN LƯỢC CAN THIỆP ĐỘNG MẠCH VÀNH DƯỚI HƯỚNG DẪN CỦA CHỤP CẮT LỚP KẾT QUANG NỘI MẠCH (OCT)

Abstract

Background: Intravascular contrast tomography (OCT) is an imaging method to assess lesion morphology before and after intervention to help optimize intervention results. Objective: Evaluate the morphology of coronary artery lesions using OCT and the change in coronary intervention strategy based on OCT compared with contrast angiography. Materials and methods: cross-sectional descriptive study on 69 patients with coronary artery disease at Kien Giang General Hospital from January 2023 to December 2023. Results: Based on lesion morphology assessed on OCT, 20.5% of lesions were thrombosed, 60.3% of lesions had thin capsules (TCFA), 55.1% of lesions had lipid lakes and 6.4% Severe calcified lesions, 44.3% of lesions split in half. After evaluation OCT changed strategy 79.7% compared to coronary angiography. The number of stents increased by 23.7%, stent length increased by 45.8%, stent size increased by 58.3%, and number of balloons increased by 54.2%. After intervention, the rate of stent tip dissection was low at 8.5% (6/71), the rate of non-attachment after the first stent placement was up to 42.3%, requiring another high-pressure balloon to re-expand. 43.7% did not expand the stent to a full area of > 80% after stent placement and needed to use a high-pressure balloon to re-expand. Conclusion: Coronary intervention under OCT guidance helps better understand the morphological nature of the lesion, the distribution of lesions within the coronary artery, thereby creating optimal intervention strategies and results.