"My name is Byeoung-Keuk Kim, working at the Yonsei University Severance Hospital. I'm the director of the Cardiovascular classroom.

As everybody can know, recently many data show us the positive findings of the IMISI guidance especially for the complex reason. So however usually most study was done by the AS the primarily the tool for the imaging guidance. But the OCT guidance Remained on some insufficient data, especially the ACS complex reason. So this study focusing on the complex reason having the ACS.

Actually this study was the subgroup analysis of the OCCUPI trials. OCCUPI trial was Presented last ESC and simultaneously publicated in the Lancet last year. So this study is in patients with complex lesions is randomly assigned into OCT guidance and angio guidance and we compare the clinical outcome.

So in this study, complex lesions include CTO or long lesions, small vessel bifurcation and lept main and AMI stent thrombosis, intra coronary thrombosis. Our subgroup analysis study is focused on a patient with HCS meaning the complex lesion HCS patient then compare the two different strategy is OCT guided and angio guided.

The primary endpoint was cardiac death, MI and stent thrombosis and TVR late at one year occupy ACS Study From the total enrolled patient from the OCCUPI trials, approximately half of patients had ACS and then among the 709 patients with ACS we compared the OCT guidance and angio guidance at one year the occurrence of a primary endpoint is the OCT guided group showed a significantly lower rate of the Primary endpoint as compared to the angio guided group in the ACS subset. Especially the over AMI rate significantly lower in the OCT guided group. And also OCT guided group showed trend toward having a lower rate of cardiac death or TVR at one year as compared to the Angiographic guided group.

This finding of ACS subset is quite similar with the Model study of OCCUPI trials. The meaning as previous told you, the lack of data supporting the ACS even with the guidelines, the use of OCT would be recommended. However, this study is also supporting the direct evidence of the OCT guidance for the treating ACS complex region. So this is focused on this study subset.

This study in Asia subset showed some significant and consistent findings. However, in the future we need more detailed OCT criteria according to the clinical presentation meaning the stable or MI or unstable angina. Definitely we need it. And also the major determinant of the OCT or angio guidance according to the clinical presentation needed and also for the perfect OCT guidance, pre stenting OCT imaging is also important. So that kind of some association between the pre OCT findings and clinical outcome is also needed in the future via planning to investigate of this.”