Abstract 17544: Reproducibility Between Online and Offline Analysis of Qualitative Optical Coherence Tomography Results After Stenting in non-ST Elevation Acute Coronary Syndromes

Introduction & Hypothesis: We evaluated reproducibility between online and offline analysis of optical coherence tomography (OCT) results of angioplasty with stent implantation in non-ST elevation acute coronary syndromes (NSTEACS). Methods: In a prospective series of consecutive patients undergoing angioplasty of a single lesion responsible for NSTEACS (symptom onset <48 h) with use of OCT to optimise procedural result, we compared presence of thrombus or tissue protrusion, residual dissection, stent malapposition, stent under-expansion, complete coverage of the lesion and side branches by the stent, as assessed online by the operator, versus results of offline analysis by two independent observers. Stent underexpansion was defined as a ratio of in-stent minimal lumen area (MLA) to average reference MLA <80%. Other definitions were based on available consensus documents. Agreement was calculated using the Kappa coefficient with 95% confidence interval (CI). Results: 31 procedures were analyzed. Mean age was 65.7±8 years; 24 (77%) were men. Lesions were situated on the left anterior descending (n=14), right coronary (n=10) or circumflex artery (n=7). Results are shown in the table. Conclusion: There is good agreement between online and offline analysis for stent malapposition, and coverage of the lesion and side branches by the stent. Conversely, presence of thrombus and/or tissue protrusion, and residual dissection is under-estimated during online evaluation.