OCT Coronary Imaging in Hyderabad — Optical Coherence Tomography at Yashoda Hospitals, Hitech City

OCT in stent optimisation — why it reduces long-term complications

The most important application of OCT at Yashoda Hospitals, Hitech City is post-stent optimisation — ensuring that after a stent is deployed, it is performing optimally before the cath lab is left. The key parameters Dr. Bhishma Chowdary assesses on post-stent OCT:

• Minimum stent area (MSA) — the smallest cross-sectional area within the stent. An MSA below the recommended threshold is the strongest predictor of future in-stent restenosis and stent thrombosis. If the MSA is inadequate, post-dilatation with a larger balloon can correct the problem before clinical complications occur.
• Stent apposition — all stent struts should be in direct contact with the vessel wall. Malapposed struts with blood flow behind them can serve as a substrate for thrombosis. OCT accurately identifies these areas and guides post-dilatation to achieve optimal apposition.
• Edge dissections — any dissection extending beyond the stent edge is identified and evaluated. Small, non-significant dissections may be safely observed, while larger dissections propagating into unstented segments often require additional stent placement.
• Stent symmetry — asymmetrical stent expansion, particularly in heavily calcified arteries, can be detected and optimised using targeted post-dilatation.

When Dr. Bhishma Chowdary uses OCT in Hyderabad

• Acute coronary syndromes — helps identify plaque rupture versus plaque erosion, supporting decisions between conservative medical therapy and interventional treatment.
• In-stent restenosis — provides definitive identification of the underlying mechanism, guiding the optimal retreatment strategy such as drug-coated balloon angioplasty, repeat stenting, or rotational atherectomy.
• Stent thrombosis — determines the cause of stent clotting, including underexpansion, malapposition, or neoatherosclerosis, helping prevent future recurrence.
• Superficial calcium assessment — accurately identifies calcium sheets and calcium fractures that may affect stent expansion and procedural outcomes.
• Post-stent optimisation in complex lesions — confirms minimum stent area (MSA), stent apposition, and stent-edge integrity following IVUS-guided stent sizing and deployment.
• TCTAP presentation case — transcatheter mitral valve-in-valve procedures assessed with intracardiac imaging and presented at the TCTAP Seoul conference.