Author + information
- Received August 2, 2018
- Revision received August 10, 2018
- Accepted August 14, 2018
- Published online November 5, 2018.
- Masahiro Katamine, MD,
- Yoshiyasu Minami, MD, PhD∗ (, )
- Tomoyoshi Yanagisawa, MD, PhD,
- Kentaro Meguro, MD, PhD,
- Takao Shimohama, MD, PhD,
- Taiki Tojo, MD, PhD and
- Junya Ako, MD, PhD
- ↵∗Address for correspondence:
Dr. Yoshiyasu Minami, Department of Cardiovascular Medicine, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara 252-0373, Japan.
A 70-year-old man underwent percutaneous coronary intervention (PCI) for a diffuse lesion at proximal right coronary artery. Optical coherence tomography (OCT) showed an additional 15-mm-length stent would be suitable to cover a residual lesion with irregular cavities (Figure 1A). However, on OCT images after the additional 15-mm-length stent implantation, the cavities were not covered by the stent despite the stent not being longitudinally deformed. The longitudinal measurement mismatch between the pullbacks was 5 mm (Figure 1B). Looking back at the angiograms, the guiding catheter and OCT catheter were withdrawn according to a deep breath (Figures 1C and 1D, Online Video 1) during the first pullback around the lesion. To avoid further multiple overlapping stents, we decided not to implant an additional stent to cover the cavities.
Herein, we report an unexpected measurement error in OCT-guided PCI due to a deep breath during the pullback. The measurement accuracy of vessel dimension in OCT is superior to angiograms or intravascular ultrasound (IVUS) (1). The superiority of accuracy regarding longitudinal measurement in OCT to IVUS is also demonstrated (2). However, in the present case, the first OCT pullback underestimated the length of a residual lesion because of a deep breath and subsequently the catheter being withdrawn. Because it was impossible to notice the mismatch between the OCT measurement and the actual length at the time, a shorter stent was deployed. Although OCT has excellent measurement accuracy, physicians should remember that external factors including deep breaths during pullback can be a cause of longitudinal measurement error.
Dr. Ako has been a consultant for Abbott Vascular. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received August 2, 2018.
- Revision received August 10, 2018.
- Accepted August 14, 2018.
- 2018 American College of Cardiology Foundation
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