Optical Coherence Tomography-Guided versus Angiography-Guided PCI

To the Editor: In the ILUMIEN IV: OPTIMAL PCI trial conducted by Ali et al. (Oct. 19 issue),(1) patients who underwent optical coherence tomography (OCT)-guided percutaneous coronary intervention (PCI) had a significantly larger minimum stent area than those who underwent angiography-guided PCI (mean difference, 0.36 mm(2)). However, this effect did not translate to a difference in clinical outcomes, including target-vessel failure (defined as a composite of death from cardiac causes, target-vessel myocardial infarction, or ischemia-driven target-vessel revascularization). Regarding safety end points, the incidence of stent thrombosis was higher in the angiography group than in the OCT group (1.4% vs. 0.5%). . . .