(CLI-OPCI) Study Executive Summary Flashcards
According to the study, what recommendations is given for Edge Dissection
Situation: Dissection is ≥ 200 μm and the dissection length is > 600 μm
Consider: Place an additional stent at the edge of the previously implanted stent
What are the recommendations for Stent Malapposition
Situation: The malapposition is > 200 μm and the malapposition length is > 600 μm
Consider: Further dilate the previously implanted stent with a noncompliant or semi-compliant balloon with a diameter of ≥ 0.25 mm larger than the previously used balloon at ≥ 14 ATM
What are the recommendations for Underexpansion
Situation: The in-stent minimal lumen area (MLA) is
≥ 90% of the average reference lumen area or ≥ 100% of reference segment lumen area with the lowest lumen area
Consider: Further dilate the previously implanted stent with a noncompliant balloon of the same diameter at ≥ 18 ATM or with a semi-compliant balloon having a diameter of ≥ 0.25 mm larger than the previously used balloon at ≥ 0.14 ATM
Thrombus
What are the recommendations if Thrombus > 200 μm and the length > 600 μm
Consider: Further dilate the previously implanted stent with a noncompliant or semi-compliant balloon of the same diameter at 8 to 14 ATM for 60 seconds
What is the Cli -OPCI study about? (Part of its title)
Angiography Alone versus Angiography plus Optical Coherence Tomography to Guide Decision-making during Percutaneous Coronary Intervention
Whats does ClI -OPCI stand for?
The Centro per la Lotta contro l’Infarto-Optimisation of Percutaneous Coronary Intervention (CLI-OPCI) study
What is the pupose of the study?
To compare angiographic guidance alone (n = 335) versus angiographic plus OCT guidance (n = 335) for PCI in 670 patients.
What did the researcher do to the OCT arm of the study
1) In the OCT arm, OCT was performed after the achievement of an optimal angiographic result.
2) All patients were followed for 12 months post-PCI.
What was the 1 year primary end point of the study
The primary endpoint of the study was the 12-month rate of
1) cardiac death or nonfatal myocardial infarction (MI).
2) Death
3) target lesion repeat revascularization (TLR)
definite stent thrombosis.
What are the 3 main focus of the study
1) Procedural feasibility and safety
2) Early outcomes (30 days)
2) Long-term (1-year) outcomes
Why did they use the protocol of 200Microns for the threshold?
The 200 μm threshold applied to several of the OCT criteria for optimal stenting is close to the resolution of IVUS. This was selected to assess the clinical impact of the 10 times higher resolution of OCT in depicting items likely to be missed by IVUS.
When was the findings presented?
Euro PCR 2012
Why was this study significant?
is the first to compare angiographic plus OCT guidance versus angiographic guidance alone for routine PCI
What are the 5 main implications derived from the study
1) OCT can be performed safely to guide routine PCI.
2) OCT guidance plus angiography resulted in a reduction in the 1-year rate of cardiac death or MI.
3) OCT discloses additional procedural issues not recognized by angiography alone in patients undergoing PCI, leading to additional interventions in one third of the cases.
4) OCT guidance on top of angiography was associated with significant clinical benefits even with multivariable analysis adjusting.
5) Contrast usage between the angio-alone and OCT groups was not significant. No significant differences in post-procedural renal function were found comparing OCT group versus the angio group.
Use not more than 3 words to describe each implication
1) safe routine PCI
2) OCT angio - 1year reduction cardiac death and MI
3) OCT reveals more, results in 1/3 additional intervention with the visible info.
4) Significant benefits even with mutivarible adjustment.
5) contrast usage not significant and no resulted renal function chnage
