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31-08-2018 | Review Article Open Access

Appropriate use criteria for optical coherence tomography guidance in percutaneous coronary interventions

Recommendations of the working group of interventional cardiology of the Netherlands Society of Cardiology

Tijdschrift:
Netherlands Heart Journal
Auteurs:
A. J. J. IJsselmuiden, E. M. Zwaan, R. M. Oemrawsingh, M. J. Bom, F. J. W. M. Dankers, M. J. de Boer, C. Camaro, R. J. M. van Geuns, J. Daemen, D. J. van der Heijden, J. W. Jukema, A. O. Kraaijeveld, M. Meuwissen, B. E. Schölzel, G. Pundziute, P. van der Harst, J. van Ramshorst, M. T. Dirksen, C. Zivelonghi, P. Agostoni, J. A. S. van der Heyden, J. J. Wykrzykowska, M. J. Scholte, H. M. Nef, M. J. M. Kofflard, N. van Royen, M. Alings, E. Kedhi
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Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1007/​s12471-018-1143-z) contains supplementary material, which is available to authorized users.

Abstract

Introduction

Optical coherence tomography (OCT) enables detailed imaging of the coronary wall, lumen and intracoronary implanted devices. Responding to the lack of specific appropriate use criteria (AUC) for this technique, we conducted a literature review and a procedure for appropriate use criteria.

Methods

Twenty-one of all 184 members of the Dutch Working Group on Interventional Cardiology agreed to evaluate 49 pre-specified cases. During a meeting, factual indications were established whereupon members individually rated indications on a 9-point scale, with the opportunity to substantiate their scoring.

Results

Twenty-six indications were rated ‘Appropriate’, eighteen indications ‘May be appropriate’, and five ‘Rarely appropriate’. Use of OCT was unanimously considered ‘Appropriate’ in stent thrombosis, and ‘Appropriate’ for guidance in PCI, especially in distal left main coronary artery and proximal left anterior descending coronary artery, unexplained angiographic abnormalities, and use of bioresorbable vascular scaffold (BVS). OCT was considered ‘Rarely Appropriate’ on top of fractional flow reserve (FFR) for treatment indication, assessment of strut coverage, bypass anastomoses or assessment of proximal left main coronary artery.

Conclusions

The use of OCT in stent thrombosis is unanimously considered ‘Appropriate’ by these experts. Varying degrees of consensus exists on the appropriate use of OCT in other settings.

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Netherlands Heart Journal

Het Netherlands Heart Journal wordt uitgegeven in samenwerking met de Nederlandse Vereniging voor Cardiologie en de Nederlandse Hartstichting. Het tijdschrift is Engelstalig en wordt gratis beschikbaa ...

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