PCI in patients with ostium coronary artery lesions: three-year follow-up
| Autor: | A. V. Mambetov, E Gitelzon, D A Maximkin, Olga Safonova, Z Shugushev, A Faibushevich, A Chepurnoy |
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| Rok vydání: | 2020 |
| Předmět: | |
| Zdroj: | European Heart Journal. 41 |
| ISSN: | 1522-9645 0195-668X |
| DOI: | 10.1093/ehjci/ehaa946.1453 |
| Popis: | Aims To increase the effectiveness of percutaneous coronary interventions (PCI) in patients with ostium coronary artery lesions. Methods 170 patients were included in the study. Inclusion criteria: ostium atheroslerotic lesions of left arterial descending (LAD) or left circumflex (LCx) >70% according to angiography and intravascular ultrasound (IVUS); myocardial ischemia according stress test and FFR measurement. All patients were randomized into 2 groups. In I group (n=85) according to IVUS, atherosclerotic plaque spread from the ostium of LAD and/or LCx to the left main coronary artery (LMCA), and in group II (n=85) - the plaque did not spread into the LMCA. In Group I all patients were initially treated with “Provisional T” stenting of the LMCA, and in Group II – precision stenting of the ostium LAD or LCx. Long-term results were evaluated on 24 and 48 months. Primary endpoints: frequency of MACE (death, MI, revascularizations). Results During hospitalization of complications associated with PCI was not, survival was 100% in all groups. The conversion to complete bifurcation stenting were in 5 patients from Group I and conversion to provisional stenting were in 3 patients from Group II. The long-term results after 24 months was observe in 70 patients from Group I and 72 patients, from Group II. Nonfatal myocardial infarction (MI) was observed in 2 (2.7%) of patients from group II and not in Group I. The incidence of hemodynamic significant stent restenosis and was observed in 4 patients (5.7%) in Group I, and in 7 patients (9.8%) in Group II (p0.05). The incidence of hemodynamic significant stent restenosis was observed in 3 patients (5.7%) in Group I, and in 5 patients (9.3%) in Group II (p Conclusions IVUS analysis of ostium stenosis of coronary arteries can help in choosing the optimal stenting technique, as well as reliably improve long-term PCI results. Patients after precision stenting of the ostium have worse long-term results, compared with patients after provisional T-stenting. Funding Acknowledgement Type of funding source: None |
| Databáze: | OpenAIRE |
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