Routine use of optical coherence tomography (OCT) to guide coronary intervention is not widespread. A prescribed OCT workflow was tested in 16 US hospitals to measure the degree of influence on procedural decision-making relative to x-ray angiography. In this analysis, implementation of OCT workflow impacted PCI decision-making over initial angiographic guidance in the majority of cases, with predominant effect in changing lesion assessment and treatment strategy, with a lesser effect on optimization after the treatment was delivered. There was a similar observed effect for both experienced and non-experienced prior users of OCT, pointing to fundamental differences in accuracy and extent of information derived from OCT vs angiography.
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