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OCT Intravascular Imaging Improves Stenting Procedure Outcomes

By MedImaging International staff writers
Posted on 04 Sep 2023

Image: The Ultreon 1.0 software is designed to optimize stent placement (Photo courtesy of Abbott)

Individuals diagnosed with coronary artery disease—a condition marked by the buildup of plaque within arteries leading to chest pain, shortness of breath, and heart attacks—often undergo percutaneous coronary intervention (PCI). This non-surgical procedure involves interventional cardiologists employing a catheter to position stents within blocked coronary arteries, thereby restoring blood flow. The most prevalent guidance method for PCI is angiography, which employs X-rays and a specialized dye (contrast material) to visualize blood flow through heart arteries and highlight any blockages. However, angiography has its limitations. It struggles to accurately determine artery size and plaque composition, and is suboptimal in identifying issues like stent expansion post-PCI and other complications that impact the procedure's effectiveness and safety. Intravascular ultrasound (IVUS) is an alternative technique offering a more precise and specific view of coronary arteries. Although studies confirm that IVUS-guided PCI surpasses angiography-guided PCI, leading to reduced cardiovascular events, its usage remains limited due to challenges in image interpretation.

A more recent technique is optical coherence tomography (OCT), which employs light, rather than sound, to create images of blockages. OCT images exhibit superior resolution, accuracy, and detail compared to IVUS, with easier interpretability. Despite these advantages, OCT is only applied in 3% of PCI cases, partially due to limited study data. The aim of this new trial is to alter this landscape. Now, a new study has found that using OCT to guide stent implantation during PCI can enhance safety and yield better outcomes for heart disease patients than relying solely on angiography. These findings are from the ILUMIEN IV: OPTIMAL PCI study which is the largest clinical trial of its kind comparing the two methods for this procedure.

The ILUMIEN IV: OPTIMAL PCI trial randomized 2,487 patients to OCT-guided PCI using a device manufactured by Abbott (Abbott Park, IL, USA) and angiography-guided PCI. The trial was conducted between May 2018 and December 2020 across 80 centers in 18 countries, with patients unaware of their assigned guided procedure. Researchers assessed post-PCI dimensions of the stented area since stent re-narrowing over time can necessitate repeat revascularization procedures. Notably, the OCT group displayed a significantly larger stent area immediately after the procedure compared to the angiography-guided group—a .36mm2 increase. OCT guidance also correlated with fewer procedural complications compared to angiography guidance.

Additionally, the study examined target lesion failure (TLF), a combination of cardiac death, target-vessel myocardial infarction, or ischemia-driven target-vessel revascularization. Two years post-procedure, 88 patients in the OCT group experienced TLF, in contrast to 99 patients in the angiography group. Although this difference did not reach statistical significance, the study delved further into stent thrombosis rates, a severe PCI complication. Within two years of PCI, six patients in the OCT group experienced stent thrombosis, while 17 patients in the angiography group encountered this issue—showing OCT's 65% reduction in such instances. Importantly, 96% of patients experiencing stent thrombosis in the trial subsequently faced death or myocardial infarction, highlighting the importance of preventing such events.

“The ILUMIEN IV trial demonstrated that OCT-guided PCI compared with angiography-guided PCI improves stent implantation results and the safety of the procedure, with less stent thrombosis, the most devastating complication of stenting,” said senior author Gregg W. Stone, MD. “However, while there were numerically fewer cardiac deaths and myocardial infarctions (MIs) in the OCT group, the differences between groups in the primary composite outcome of cardiac death or MIs or repeat revascularization related to the treated vessel was not significant.”

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65 (957.96585083008): select jos_facebook.link from jos_facebook where cat=10

66 (!!!!! 5418.062210083): select jos_google_plus.link from jos_google_plus where cat=10

67 (566.95938110352): select jos_linkedin.link from jos_linkedin where cat=10

68 (129.93812561035): SELECT fid FROM jos_deeppockets WHERE id=294798500 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294798500 AND published='1' LIMIT 1

69 (762.939453125): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=211 ORDER BY `ordering`

70 (351.90582275391): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294798500 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (!!!!! 3136.8732452393): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294798500 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (!!!!! 1237.8692626953): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

73 (!!!!! 1396.1791992188): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (174.04556274414): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (909.09004211426): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (149.96528625488): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (70.095062255859): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (136.8522644043): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (145.91217041016): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (!!!!! 1425.9815216064): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294798500 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (418.90144348145): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294798500 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (111.10305786133): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

90 (!!!!! 1230.001449585): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (245.09429931641): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (140.90538024902): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (160.93254089355): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (131.13021850586): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (388.14544677734): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (329.01763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (132.08389282227): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (87.02278137207): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (247.00164794922): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (569.82040405273): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (!!!!! 7513.9999389648): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798500 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798500 AND published='1' LIMIT 1

105 (72.956085205078): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798500 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798500 AND published='1' LIMIT 1

106 (!!!!! 2946.138381958): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294798500 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (!!!!! 1054.048538208): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294798500 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (787.01972961426): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798500 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798500 AND published='1' LIMIT 1

109 (152.1110534668): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798500 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798500 AND published='1' LIMIT 1

110 (141.14379882812): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294798500 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (!!!!! 2032.0415496826): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294798500 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (!!!!! 1336.0977172852): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

113 (591.03965759277): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

114 (818.01414489746): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798500 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798500 AND published='1' LIMIT 1

115 (619.17304992676): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798500 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798500 AND published='1' LIMIT 1

116 (!!!!! 1982.9273223877): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798500 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798500 AND published='1' LIMIT 1

117 (185.01281738281): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798500 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798500 AND published='1' LIMIT 1

118 (205.03997802734): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798500 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798500 AND published='1' LIMIT 1

119 (!!!!! 1082.8971862793): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798500 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798500 AND published='1' LIMIT 1

120 (!!!!! 1020.9083557129): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

121 (!!!!! 102908.84971619): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

122 (62.942504882812): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798500 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798500 AND published='1' LIMIT 1

123 (48.160552978516): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798500 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798500 AND published='1' LIMIT 1

124 (449.89585876465): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294798500 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294798500 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 1922385.931015): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

126 (!!!!! 1148011.9228363): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

127 (77.962875366211): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

128 (30.994415283203): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

129 (41.007995605469): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

130 (30.040740966797): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

131 (27.894973754883): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

132 (135.89859008789): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

133 (611.0668182373): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798500 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

134 (514.03045654297): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798500 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

135 (238.89541625977): SELECT name FROM jos_deeppockets WHERE id=211

136 (269.17457580566): SELECT name FROM jos_deeppockets WHERE id=211

137 (806.09321594238): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))211((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

138 (!!!!! 1114.1300201416): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))211((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

139 (!!!!! 4553.7948608398): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798500 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798500 AND published='1' LIMIT 1

140 (550.98533630371): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798500 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798500 AND published='1' LIMIT 1

141 (!!!!! 43157.815933228): TRUNCATE TABLE jos_trademed_module

142 (!!!!! 1173.0194091797): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294798500 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

143 (807.04689025879): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294798500 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

144 (!!!!! 7261.0378265381): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798500 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

145 (!!!!! 1672.0294952393): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798500 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

146 (524.99771118164): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798500 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798500 AND published='1' LIMIT 1

147 (57.93571472168): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798500 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798500 AND published='1' LIMIT 1

148 (!!!!! 1090.0497436523): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

149 (77.962875366211): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798500 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798500 AND published='1' LIMIT 1

150 (55.074691772461): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798500 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798500 AND published='1' LIMIT 1

151 (343.08433532715): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294798500 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294798500 AND type='deeppockets_item' AND published='1' LIMIT 1

152 (461.10153198242): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=211 or channel_id is null)

153 (27.894973754883): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=211 or channel_id is null)

154 (29.802322387695): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

155 (!!!!! 3023.8628387451): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798500 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798500 AND published='1' LIMIT 1

156 (80.108642578125): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798500 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798500 AND published='1' LIMIT 1

157 (101.08947753906): select jos_twitters.link from jos_twitters where cat=10

158 (26.941299438477): select jos_facebook.link from jos_facebook where cat=10

159 (26.941299438477): select jos_google_plus.link from jos_google_plus where cat=10

160 (25.98762512207): select jos_linkedin.link from jos_linkedin where cat=10

161 (232.93495178223): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

162 (!!!!! 6500.9593963623): insert into jos_banners_delta values (14615,'2025-04-29 21:11:18','18.119.99.38','view'),(14202,'2025-04-29 21:11:18','18.119.99.38','view'),(14203,'2025-04-29 21:11:18','18.119.99.38','view')

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