3D OCT and Bifurcations OPTICS IN CARDIOLOGY ZÜRICH 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, Skejby ● Denmark SKEJBY
3D OCT Okamura et al. EuroIntervention 2018 PCI Research Aarhus University Hospital niels.holm@clin.au.dk Aarhus University Hospital, Skejby ● Denmark SKEJBY
3D OCT PCI Research Aarhus University Hospital niels.holm@clin.au.dk Aarhus University Hospital, Skejby ● Denmark SKEJBY
3D OCT PCI Research Aarhus University Hospital niels.holm@clin.au.dk Aarhus University Hospital, Skejby ● Denmark SKEJBY
3D OCT Holm et al EuroIntvervention 2015 PCI Research Aarhus University Hospital niels.holm@clin.au.dk Aarhus University Hospital, Skejby ● Denmark SKEJBY
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
2D OCT Holm et al. In review PCI Research Aarhus University Hospital niels.holm@clin.au.dk Aarhus University Hospital, Skejby ● Denmark SKEJBY
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
3D OCT CourtesyTroels Munck Nielsen, Aarhus University Hospital PCI Research Aarhus University Hospital niels.holm@clin.au.dk Aarhus University Hospital, Skejby ● Denmark SKEJBY
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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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