Mother-and-child catheter-facilitated optical coherence tomography: A novel approach to improve intracoronary imaging

Abstract

Background: Our aim was to prospectively analyze the usefulness of mother-and-child catheter approach with the GuideLiner® (GL) catheter extension system to overcome some potential limitations associated with the use of optical coherence tomography (OCT). Methods: We included consecutive patients referred to our institution for coronary angiogram in whom OCT image acquisition was obtained using GL. From February 2015 to May 2016, a total of 19 procedures (18 patients) were prospectively included. Results: In more than two thirds of the procedures, the OCT catheter was unable to cross the coronary stenosis prior to the use of GL. The right coronary artery was the most frequently involved coronary vessel (63%). The main reason for using GL (47% of cases) was poor engagement of the coronary ostium and lack of support of the guiding catheter (47%). Eventually, in 18 out of 19 procedures, a good quality OCT image was obtained and, when indicated, successful percutaneous coronary intervention with stent implantation was performed. Of note, there were no serious complications related to the use of GL during OCT imaging. Conclusions: Optical coherence tomography through a catheter extension system is a useful technique able to overcome some of the limitations associated with this imaging technique ensuring adequate blood clearance and thus optimal image quality.