Optical coherence tomography for optimal stent implantation: what to check?

Optical coherence tomography for optimal stent implantation: what to check?100% ideal for a perfect PCI result but unlikely in many lesions Non-extreme values (80%) provide satisfactory outcomes Very important for outcome Measured by MSA (mm ): Caution for MSA <4.5-5.2 mm 2 , but no unique golden value established Overexpansion (>110-120%) potentially detrimental 1 Measured by MSE (%): 2 If caused by unintended stent deformation: strong clinical impact If major (>400m): possible clinical impact 0% ideal for a perfect PCI result but unlikely in most vessels If minor (<300-400m): negligible clinical impact Stent malapposition: Di cult grading, but adverse prognosis when associated with important lumen reduction (MLA <4.5 mm ) Ideally absent when healthy-to-healthy stent coverage is feasible Residual edge disease: Common anytime landing areas are diseased and with eccentric shape Major (>60 degrees, length >600m) probably clinically impactful Ideally absent when healthy-to-healthy stent coverage is feasible Minor not clinically impactful Edge dissection: Stent expansion:OCT assessment after stent implantation for eventual optimisation.Among various OCT measurements, the key aspect to check after stent implantation are related to stent expansion, presence of dissections and/or residual disease at the stent edges, and stent malapposition.MSA, minimum stent area; MSE, minimum stent expansion; MLA, minimum lumen area.