Consultant Cardiologist Stuart Watkins and Cardiology Research Nurse Louise Graham with Scotland's first OCTOBER
Trial patient David Newman
The Golden Jubilee National Hospital has recruited its first patients into a trial using technology which could improve the treatment of complex narrowed heart arteries.
The OCTOBER Trial will monitor patients with angina or stabilised heart attacks who are found to have a significant narrowing involving a branch point (bifurcation) within the artery, during their coronary angiogram.
These branch points are one of the most problematic for interventional cardiologists who say treating this type of heart disease with stents carries a higher risk of the stent narrowing, or acutely blocking, over time.
The Europe-wide trial is aiming to compare whether Optical Coherence Tomography (OCT)-guided revascularisation can benefit patients requiring stents inserted at branch points (bifurcations), as opposed to the current standard angiographically-guided method.
Specialists believe using OCT to treat the more complex branch point narrowings could lower the risk of stents narrowing and blocking after they have been implanted in patients, and hope the study will prove this.
Consultant Cardiologist Stuart Watkins, who is the principle investigator for the trial at NHS Golden Jubilee, said: “The OCTOBER Trial aims to investigate if using OCT to treat narrowed arteries involving a branch point, which are more complicated to treat, is beneficial to patients compared to the standard procedure.
“Stents come out of their packaging in the form of a straight tube, so if you have a narrowing involving a branch point within an artery, these are more complicated to treat and require more complex techniques.
“OCT provides the most detailed images of inside a patient’s artery that we can get, giving the cardiologist a lot of information which can help guide the procedure and ensure we achieve an excellent result from our treatment.
“We have randomised the first Scottish patient into the trial and are currently actively screening for patients, who have complex coronary artery disease, who can participate and possibly benefit from this technology and new way of working.”
OCT is an imaging technique which uses light within a heart artery to give specialists very detailed images of the coronary disease they are treating, to help them choose the appropriate tools to prepare the narrowing for a stent, as well as accurately measuring the size of stent needed.
In addition, once the stent has been inserted, OCT can be used to ensure the stent is perfectly expanded and hasn’t caused any damage to the artery at either end of the stent.
Scotland’s first patient in the trial, David Newman from North Uist, said since his stent was done his health has improved dramatically.
He said: “When I visited my GP shortly after my stent operation I was told the results were ‘excellent’ and that I could go back to my normal life.
“I’ve since climbed my first hill post-op – Reuval on Benbecula – with two of my nephews and I was amazed at how much easier I found it. I feel so much better and I’m very grateful that I’ve been given the chance to get back to my former fitness so quickly.”
NHS Golden Jubilee Associate Medical Director, Alistair Macfie, said: “NHS Golden Jubilee is always at the forefront of developing new and innovative ways to treat patients better through our respected Research Centre.
“We are very excited to be part of this important trial which has the potential to not only improve the lives of patients, but to also save lives. This is why research and the participation of patients, which we are extremely grateful for, is so vital.”
NHS Golden Jubilee is hoping to recruit at least 20 patients into the international multicentre trial. So far more than 420 patients out of an expected 1,200 form across Europe have been randomised in the study.