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Abstract:

Introduction: development of intravascular diagnostic methods has significantly increased the amount of information in the study of various vessels in comparison with standard angiography. Technological and software improvement of optical coherence tomography (OCT) allows expanding diagnostic capabilities and providing greater convenience for analyzing of results of this method of intravascular examination, which leads to an increase in its importance both for daily clinical practice and in scientific research.

Aim: was to describe the methodology of performing a new modification of OCT and to analyze accumulated experience, advantages and possibilities provided by this method.

Material and methods: the modern version of the complex for optical coherence tomography OPTIS allows to implement such new features as automatic indication of malapposition of stents, easy-to-perceive three-dimensional image of examination data in various versions, joint presentation (co-registration) of angiography and OCT data in real time. The first experience of clinical use of this system in the Russian Federation is presented, with an analysis of priority indications for the use of new possibilities. Using the angio-OCT-co-registration function, 309 studies of 205 arteries in 178 patients were performed, which accounted for 63,3% of all OCT procedures performed in our department. 

Results: priority indications for the use of the method were identified, which primarily include: cases of extended stenoses with an uncertainty in the hemodynamic significance of individual sections or the entire lesion as a whole; difficulties in constructing an optimal projection of the angiogram (without overlapping branches and significant shortening of the target area); bifurcation lesions; diagnostics of thrombus, dissections, plaque ruptures, severe calcification, including in acute coronary syndrome; selection of the optimal size of biodegradable scaffold and preparation of the artery for its implantation; intermediate or final control of results of coronary artery stenting. The use of co-registration of angiography and OCT contributes to a more accurate determination of the area of interest during repeated studies, which is especially important for the dynamic assessment of the patient's condition and for scientific research.

Conclusions: the development and modernization of optical coherence tomography causes an increase in its importance both in daily clinical practice and in scientific research. The possibility of spatial co-registration of OCT data with angiographic images, as well as new options for automatic processing of resulting images, including stent apposition assessment, significantly increase the operator's ability to quickly and accurately analyze examination data directly at the operating table.

 

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