The Official Journal of EuroPCR and the European Association of Percutaneous Coronary Interventions (EAPCI)
Identification of the type of stent with three-dimensional optical coherence tomography: the SPQR study
Carlos Cortés1,2; Miao Chu3,4; Michele Schincariol5; Miguel Ángel Martínez-Hervás Alonso3; Bernd Reisbeck3; Ruiyan Zhang6,7; Yoshinobu Murasato6; Shao-Liang Chen9; Francesco Lavarra10; Shengxian Tu4; Sigmund Silber11; Juan Luis Gutierrez-Chico1,3,12
1. Klinikum Frankfurt (Oder), Germany 2. San Pedro Hospital, Logroño, Spain 3. Cardiology Department, Campo de Gibraltar Health Trust, Algeciras, Spain 4. Med-X Research Institute, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China 5. Klinikum Fürth, Cardiology Department, Germany 6. Ruijin Hospital, Shanghai, China 7. Medical University, Shanghai Jiao Tong University, Shanghai, China 8. Kyushu Medical Center, Fukuoka, Japan 9. Nanjing First Hospital, Nanjing, China 10. Jilin Heart Hospital, Changchun, China 11. Cardiology Practice, Munich, Germany 12. DRK Klinikum Westend, Berlin, Germany
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Background: The ability of optical coherence tomography (OCT) to identify specific types of stent has never been systematically studied.
Methods and results: A series of 212 consecutive patients with OCT from six international centres were retrospectively screened, finding 294 metallic stents or scaffolds in 146 patients. The sample was analysed by two blinded operators, applying a dedicated protocol in 4 steps to identify the type of stent: 1) 3D and automatic strut detection (ASD), 2) 3D tissue view, 3) Longitudinal view with ASD, 4) Mode “stent only” and ASD. The protocol correctly identified 285 stents (96.9%, kappa 0.965), with excellent interobserver agreement (kappa 0.988). The performance tended to be better in recently implanted stents (kappa 0.993) than in stents implanted ≥3 months before (kappa 0.915), and in pullback speed 18mm/s as compared with 36 mm/s (kappa 0.969 vs. 0.940, respectively).
Conclusion: The type of stent platform can be accurately identified in OCT by trained analysts following a dedicated protocol, combining 3D-OCT, ASD and longitudinal view. This might be clinically helpful in scenarios of device failure and for the quantification of apposition. The blinding of analysts in OCT studies should be revisited.