Efficacy of a new generation intracoronary optical coherence tomography imaging system with fast pullback

Objectives We sought to investigate whether a novel, fast‐pullback, high‐frequency optical coherence tomography (HF‐OCT) imaging system enables data acquisition with a reduced amount of contrast agents while retaining the same qualitative and quantitative lesion assessment to conventional OCT. Background The increased amount of administered contrast agents is a major concern when performing intracoronary OCT. Methods The present study is a single‐center, prospective, observational study including 10 patients with stable coronary artery disease. A total of 28 individual coronary arteries were assessed by both fast‐pullback HF‐OCT and by conventional OCT. Results The contrast volume used in each OCT run for the HF‐OCT system was significantly lower than for the conventional OCT system (5.0 ± 0.0 mL vs. 7.8 ± 0.7 mL, respectively, with a mean difference of −2.84 [95% confidence interval [CI]: −3.10 to −2.58]). No significant difference was found in the median value of the clear image length between the two OCT systems (74 mm [interquartile range [IQR]; 63, 81], 74 mm [IQR; 71, 75], p = 0.89). Fast‐pullback HF‐OCT showed comparable measurements to conventional OCT, including minimum lumen area (3.27 ± 1.53 mm2 vs. 3.21 ± 1.53 mm2, p = 0.27), proximal reference area (7.03 ± 2.28 mm2 vs. 7.03 ± 2.34 mm2, p = 0.96), and distal reference area (5.93 ± 1.96 mm2 vs. 6.03 ± 2.02 mm2, p = 0.23). Qualitative OCT findings were comparable between the fast‐pullback HF‐OCT runs and conventional OCT with respect to identifying lipid‐rich plaques, calcifications, layered plaques, macrophages, and cholesterol crystals. Conclusion With the fast pullback function of a novel HF‐OCT imaging system, we acquired OCT images using a significantly lower amount of contrast volume while retaining a comparable qualitative and quantitative lesion assessment to conventional OCT.