Optimal Stenting Technique for Complex Coronary Lesions
| Autor: | Soo-Jin Kang, Sangwoo Park, Duk-Woo Park, Jung-Bok Lee, Seung-Jung Park, Pil Hyung Lee, Young-Hak Kim, Hanbit Park, Do-Yoon Kang, Cheol Whan Lee, Seung-Whan Lee, Jung-Min Ahn, Euihong Ko, Sang-Cheol Cho, Seong-Wook Park |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Interventional cardiology medicine.diagnostic_test business.industry medicine.medical_treatment Hazard ratio Stent Percutaneous coronary intervention 030204 cardiovascular system & hematology medicine.disease Coronary artery disease 03 medical and health sciences 0302 clinical medicine medicine.anatomical_structure Internal medicine Intravascular ultrasound medicine Cardiology 030212 general & internal medicine Myocardial infarction Cardiology and Cardiovascular Medicine business Artery |
| Zdroj: | JACC: Cardiovascular Interventions. 13:1403-1413 |
| ISSN: | 1936-8798 |
| DOI: | 10.1016/j.jcin.2020.03.023 |
| Popis: | Objectives This study compared the 3-year outcomes of intracoronary imaging–guided pre-dilation, stent sizing, and post-dilation (iPSP) for patients with complex coronary artery lesions. Background The long-term effects of the optimal drug-eluting stent implantation technique in complex coronary artery disease have not been evaluated. Methods From the IRIS-DES (Interventional Cardiology Research In-cooperation Society-Drug-Eluting Stents) registry, the study evaluated 9,525 patients who underwent percutaneous coronary intervention for left main, bifurcation, long or diffuse (>30 mm), or angiographically severely calcified lesions. The primary outcome was a composite of cardiac death, target vessel myocardial infarction, and target vessel revascularization. The inverse probability of treatment weighting method was used to adjust for confounding factors. Results At the index procedure, intravascular ultrasound assessment PSP were performed in 8,522 (89.5%) patients, 5,141 (54.0%) patients, and 5,531 (58.1%) patients, respectively; overall, 3,374 (35.4%) patients underwent stent implantation using all 3 parts of the iPSP strategy and were defined as the iPSP group. At 3 years, the adjusted rate of the primary outcome was significantly lower in iPSP group (5.6% vs 7.9%; adjusted hazard ratio: 0.71; 95% confidence interval: 0.63 to 0.81; p Conclusions Among patients undergoing drug-eluting stent implantation in complex coronary artery stenosis, iPSP was associated with a lower risk of cardiac events at 3 years. Therefore, physicians should apply iPSP more actively for the treatment of complex coronary artery stenoses, even in the current era. (Evaluation of the First, Second, and New Drug-Eluting Stents in Routine Clinical Practice [IRIS-DES]; NCT01186133) |
| Databáze: | OpenAIRE |
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