Does a well developed collateral circulation predispose to restenosis after percutaneous coronary intervention? An intravascular ultrasound study
| Autor: | Lucy Blows, Rizwan Rashid, Michael S. Marber, Divaka Perera, Simon Redwood, Pieter Postema, S J Patel |
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| Přispěvatelé: | Graduate School |
| Rok vydání: | 2005 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Collateral Circulation Lumen (anatomy) Cardiovascular Medicine Coronary Angiography Coronary Restenosis Restenosis Predictive Value of Tests Risk Factors Internal medicine Angioplasty Intravascular ultrasound medicine Humans Prospective Studies cardiovascular diseases Angioplasty Balloon Coronary Ultrasonography medicine.diagnostic_test business.industry Coronary Stenosis Stent Percutaneous coronary intervention Middle Aged Collateral circulation medicine.disease Case-Control Studies Conventional PCI Cardiology Female Stents Cardiology and Cardiovascular Medicine business |
| Zdroj: | Heart, 92(6), 763-767. BMJ Publishing Group |
| ISSN: | 1355-6037 |
| DOI: | 10.1136/hrt.2005.067322 |
| Popis: | Objective: To evaluate whether a well developed collateral circulation predisposes to restenosis after percutaneous coronary intervention (PCI). Design: Prospective observational study. Patients and setting: 58 patients undergoing elective single vessel PCI in a tertiary referral interventional cardiac unit in the UK. Methods: Collateral flow index (CFI) was calculated as (Pw-Pv)/(Pa-Pv), where P a, Pw, and Pv are aortic, coronary wedge, and right atrial pressures during maximum hyperaemia. Collateral supply was considered poor (CFI < 0.25) or good (CFI ≥ 0.25). Main outcome measures: In-stent restenosis six months after PCI, classified as neointimal volume ≥ 25% stent volume on intravascular ultrasound (IVUS), or minimum lumen area ≤ 50% stent area on IVUS, or minimum lumen diameter ≤ 50% reference vessel diameter on quantitative coronary angiography. Results: Patients with good collaterals had more severe coronary stenoses at baseline (90 (11)% v 75 (16)%, p < 0.001). Restenosis rates were similar in poor and good collateral groups (35% v 43%, p = 0.76 for diameter restenosis, 27% v 45%, p = 0.34 for area restenosis, and 23% v 24%, p = 0.84 for volumetric restenosis). CFI was not correlated with diameter, area, or volumetric restenosis (r2 < 0.1 for each). By multivariate analysis, stent diameter, stent length, > 10% residual stenosis, and smoking history were predictive of restenosis. Conclusion: A well developed collateral circulation does not predict an increased risk of restenosis after PCI. |
| Databáze: | OpenAIRE |
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