IVUS guided versus OCT guided PCI among patients presenting with Acute Coronary Syndrome

Abstract Purpose We aimed to compare the procedural and short-term outcomes between IVUS guided and OCT guided percutaneous coronary interventions in patients presenting with acute coronary syndrome (ACS). Methods In the present retrospective study, we reviewed the data of 50 patients who had IVUS-guided PCI and 50 patients who had OCT-guided PCI for ACS between January 2021 and June 2021. Intravascular imaging was done before and after stenting. Both groups were compared in terms of minimal luminal area (MLA), stent dimensions, final minimal stent area (MSA) and stent expansion as well as negative angiographic outcomes. Patients were followed for six months to record MACE. Results The mean age of analyzed patients was 57 ± 13 years with male predominance (78%). The radiation time and dose were significantly higher among IVUS group. Pre-stenting MLA was significantly higher in IVUS group (2.63mm vs 2.22 mm in OCT, P = 0.013). Stent expansion was significantly higher among OCT group (97% vs 93% in IVUS group, P = 0.001) with no significant difference between both groups regarding MSA [mm2] (8.88 ± 2.87 in IVUS vs 8.1 ± 2.76 in OCT, P = 0.169). No significant difference between both groups was noted regarding contrast volume, edge dissection and no reflow. The rates of six-months MACE were significantly higher in the IVUS group. Conclusion OCT-guided PCI in ACS is safe and associated with similar MSA to that of IVUS-guided PCI.