Authors: Mohammad Reza Movahed, MD 1,2
University of Arizona Sarver Heart Center, Tucson,
Arizona,1 University of Arizona,
Phoenix,2
Correspondent:
M Reza Movahed, MD, PhD, FACP, FACC, FSCAI
Clinical Professor of Medicine
University of Arizona Sarver Heart Center
1501 North Campbell Avenue
Tucson, AZ 85724
Email: Rmova@aol.com
Tel: 949 400 0091
Key words: Percutaneous coronary intervention; stenting;
balloon angioplasty: bifurcation lesion; acute coronary syndrome; acute
myocardial infarction; unstable angina;PCI
Conflict of interest: None
With great interest, I read the paper entitled: “OCT or Angiography
Guidance for PCI in Complex Bifurcation Lesions” published in the New
England Journal of Medicine. (1) The Authors did a great job in
randomizing patients to optical coherent tomography (OCT) vs. no
OCT-guided bifurcation intervention. However, the most important
anatomic features of a given bifurcation lesion were not mentioned and
not studied at all. It is important that only true bifurcation lesions
called B2 lesions (B for bifurcation, 2 meaning both ostia have
significant disease) based on the Movahed bifurcation classification
(2-4) needs a complex approach including the use of OCT. Not separating
their bifurcation lesions into true vs. not true bifurcation lesions,
they are not able to answer the simple questions: Do we really need OCT
in non-true bifurcation lesions? Unfortunately, by not having any
analysis of this important anatomical feature in this manuscript, the
benefit of OCT remains uncertain for true or non-true lesions that could
lead to under or overuse of OCT during bifurcation coronary
interventions.