Abstract
Background: Percutaneous coronary intervention (PCI) guided by optical coherence tomography (OCT) optimizes stent implantation and improves long-term outcomes. Real-world data from hospitals in Vietnam remain scarce. Objectives: To determine procedural success rates, OCT-defined coronary plaque morphology, rates of edge dissection, malapposition, and underexpansion, and to identify associated clinical and procedural factors. Methods: Prospective cohort study of 361 patients undergoing OCT-guided PCI at Kien Giang General Hospital. Univariable and multivariable logistic regression analyses were performed. Results: Procedural success rate was 87.8%. Lesion morphology included fibrous (96.4%), calcium (65.9%), lipid pool (64.3%), TCFA (37.4%), and bifurcation (55.1%). Adequate stent apposition was achieved in 89.2%, and stent expansion >80% in 85.6% of cases. Edge dissection occurred in 12.2% and malapposition in 8.0%. Mean MSA was 5.75 ± 2.26 mm². Independent predictors of malapposition included ACS (aOR=2.99), dyslipidemia (aOR=3.20). Conclusion: OCT-guided PCI achieved a high procedural success rate in Viet Nam hospital setting. OCT detected a significant burden of complex plaque morphology and facilitated stent optimization. ACS and dyslipidemia were independent predictors of stent malapposition.
