OCT was no worse than ultrasound for left main bifurcation stenting
Optical coherence tomography guidance came out no worse than intravascular ultrasound for true distal left main bifurcation lesions. Target lesion failure at 12 months was 14.4 per cent with OCT and 19.6 per cent with ultrasound. That composite covers cardiac death, target lesion-related myocardial infarction and clinically indicated revascularisation, and held when periprocedural infarctions were excluded. A new universal definition now sorts every heart attack into primary, secondary and procedure-related groups, the last covering infarction within 30 days of a cardiac procedure.
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Target lesion failure was 14.4 per cent with OCT and 19.6 per cent with ultrasound
Optical coherence tomography was compared with intravascular ultrasound guidance in patients with true distal left main bifurcation lesions. The comparison ran at 24 centres in China. Over a median 362 days of follow-up, 12-month target lesion failure was 14.4 per cent with OCT and 19.6 per cent with ultrasound. Target lesion failure combines cardiac death, target lesion-related myocardial infarction and clinically indicated target lesion revascularisation. Mean age was 63.5 years and 22.1 per cent of patients were women.[1]
The finding held when periprocedural infarctions were excluded
The result held when periprocedural infarctions were excluded. Yong Zeng of Beijing Anzhen Hospital and Capital Medical University said OCT guidance may be considered an alternative to ultrasound in appropriately selected patients. Anatomy, feasibility and local expertise still decide the choice. The comparison does not establish that the two methods are equivalent or that either is superior.[1]
Heart attacks now sort into primary, secondary and procedure-related
The fifth universal definition of myocardial infarction sorts every heart attack into primary, secondary and procedure-related. Primary covers events in the artery itself, such as plaque rupture, spontaneous dissection, spasm or clotting; secondary covers an oxygen supply-and-demand imbalance that sits with another illness; the third group covers infarction within 30 days of cardiac surgery or a cardiac procedure. Nicholas Mills said the old numbered scheme was not always easy to apply in practice and diagnosis and treatment were inconsistent. Kristin Newby said the plain categories give a clinician a way to explain the infarction grouping to a patient instead of quoting a number. The document is also aligned with ICD-11 coding. As a consensus standard it covers how events are classified rather than how they are treated.[2]
