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Abbott @AbbottCardio
, 7 tweets, 6 min read Read on Twitter
1/Welcome to our third #OCTober #Tweetorial 🎃🤓. Here we’ll talk
about how #OCTImaging can help detect the mechanisms of in-stent
restenosis (ISR) to guide treatment. #imagefirst #imagelast

Important Safety Info:
2/ What causes ISR? Stent underexpansion and neointimal hyperplasia (NIH) are the two predominant mechanisms of stent failure, as cited in this expert consensus document of the European Association of PCI:

Important Safety Info:
3/Here’s how stent underexpansion and NIH are seen on angiography and OCT respectively. To spot NIH, look for a large layer of growth on top of an already fully expanded stent.

Important Safety Info:
4/ Full screen view: From the longitudinal section, you can see the tight area. Looking at the cross-section aligning to it, you can see it’s NIH. The stent rendering feature is only picking up on areas w/o NIH. TY @ZiadAliNyc  

Important Safety Info:
5/Here’s a video screen capture of an ISR due to NIH using the OCT playback mode. While examining the run on the system, you are able to scroll through at your own pace to examine the morphology. Video courtesy Rich Shlofmitz, MD.

Important Safety Info:
6/Because of its high resolution (10x greater than IVUS), #OCTimaging allows you to see not only NIH, but also the number of stents, stent malapposition, tissue protrusion, and edge dissections.

Important Safety Info:
7/By using #OCTimaging to diagnose the mechanism of ISR, you can select the right treatment strategy, as seen in this chart developed by @ZiadAliNyc

Important Safety Info:
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