{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,9]],"date-time":"2025-11-09T03:49:27Z","timestamp":1762660167567,"version":"3.37.3"},"reference-count":13,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,3,3]],"date-time":"2022-03-03T00:00:00Z","timestamp":1646265600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Optical coherence tomography (OCT) is a high\u2010resolution imaging modality that provides a precise evaluation of coronary anatomy. However, the presence of severe coronary lesions can prevent the required adequate distal contrast flushing resultting in inadequate blood clearance and poor image quality or complete blood shadowing of the underlying vessel wall.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>The aim of this prospective study was to evaluate the feasibility and safety of a novel \u201cdouble injection technique\u201d (DIT) to overcome the limitations of the conventional technique (CT) in patients with severely stenotic lesions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Twenty\u2010three patients with severe angiographic lesions were sequentially imaged before intervention with OCT with the CT and then with DIT. A total of 5125 OCT frames were carefully matched and analyzed by an independent central core lab. A semiquantitative image quality score was used to grade the number of quadrants (0\u20134) with vessel wall visualization.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Optimal OCT visualization (Grades 3\u20134) significantly improved by the DIT (68% vs. 38% of frames, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). The DIT also improved the mean score (3.1\u2009\u00b1\u20090.6 vs. 2.0\u2009\u00b1\u20090.8; p\u2009&lt;\u20090.05; mean improvement of 1.1\u2009\u00b1\u20090.5 per patient). There were no complications associated with the DIT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The DIT significantly improved preintervention image quality of OCT in severe coronary lesions.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.30138","type":"journal-article","created":{"date-parts":[[2022,3,3]],"date-time":"2022-03-03T13:59:34Z","timestamp":1646315974000},"page":"1511-1517","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The double injection technique to improve visualization of severe coronary lesions with optical coherence tomography"],"prefix":"10.1002","volume":"99","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3676-0277","authenticated-orcid":false,"given":"Fernando","family":"Rivero","sequence":"first","affiliation":[{"name":"Department of Cardiology, Hospital Universitario de la Princesa Universidad Aut\u00f3noma de Madrid, IIS\u2010IP, CIBERCV Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valeria","family":"Marco","sequence":"additional","affiliation":[{"name":"Centro per la Lotta Contro L' Infarto\u2013CLI Foundation Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Flavio Giuseppe","family":"Biccir\u00e8","sequence":"additional","affiliation":[{"name":"Centro per la Lotta Contro L' Infarto\u2013CLI Foundation Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8686-7304","authenticated-orcid":false,"given":"Simone","family":"Budassi","sequence":"additional","affiliation":[{"name":"Centro per la Lotta Contro L' Infarto\u2013CLI Foundation Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6462-0485","authenticated-orcid":false,"given":"Javier","family":"Cuesta","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Universitario de la Princesa Universidad Aut\u00f3noma de Madrid, IIS\u2010IP, CIBERCV Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"del Val","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Universitario de la Princesa Universidad Aut\u00f3noma de Madrid, IIS\u2010IP, CIBERCV Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1544-9594","authenticated-orcid":false,"given":"Teresa","family":"Bastante","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Universitario de la Princesa Universidad Aut\u00f3noma de Madrid, IIS\u2010IP, CIBERCV Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hortensia","family":"de la Fuente","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Universitario de la Princesa Universidad Aut\u00f3noma de Madrid, IIS\u2010IP, CIBERCV Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0312-2030","authenticated-orcid":false,"given":"Francesco","family":"Prati","sequence":"additional","affiliation":[{"name":"Centro per la Lotta Contro L' Infarto\u2013CLI Foundation Rome Italy"},{"name":"UniCamillus\u2013Saint Camillus International University of Health Sciences Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7480-2511","authenticated-orcid":false,"given":"Fernando","family":"Alfonso","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Universitario de la Princesa Universidad Aut\u00f3noma de Madrid, IIS\u2010IP, CIBERCV Madrid 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