Optical Coherence Tomography Predictors of Functionally Significant Side Branch Compromise After Provisional Main Vessel Stenting In Calcific Coronary Artery Disease Assessed by Fractional Flow Reserve
The purpose of this study is to predict any changes in the side branch after stenting the main branch blood vessel using three dimensional intravascular images. (Frequency domain optical coherence tomography FD OCT). Optical coherence tomography (OCT) is an established medical imaging technique that uses light to capture high-resolution, three-dimensional images of blood vessels. These images will be used before and after implanting the stent in the main blood vessel. Fractional Flow Reserve (FFR) test, which makes it possible for the interventional cardiologist to calculate blood flow across an area of a coronary artery, will be done after stenting and will help to determine if there are any changes in the side branch blood flow.
• All patients over 18 years of age presenting with stable coronary artery disease.
• Patients must have a clinical indication for coronary intervention.
• Creatinine Kinase Myocardial-Band Isoenzyme (CK-MB) must be less than or equal to the upper limit of lab normal (ULN) value within eight hours prior to the procedure.
• The target lesion must be a de novo calcified bifurcation coronary lesion that hasn't been previously treated with any interventional procedure for which provisional main vessel stenting strategy is planned after reviewing angiogram.
• The target vessel must be a native coronary artery with
‣ stenosis ≥70% and \<100%, or
⁃ Stenosis ≥50% and \<70% with evidence of clinical ischemia via positive stress test, or FFR ≤ 0.8, or IVUS or OCT minimal lumen area ≤ 4.0 mm2.
• The target lesion should have SB DS 30 - 70%.
• The target main vessel reference diameter must be ≥2.5 mm and ≤ 4.0 mm.
• The SB reference diameter must be \> 2 mm by coronary angiogram.
• The target vessel must have a Thrombolysis in Myocardial Infarction (TIMI) flow grade 3 at baseline.