Usefulness of the Finet law to guide stent size selection in ostial left main stenting: Comparison with standard angiographic estimation
| Autor: | Stefano Perilli, Daniele Cavazzini, Gianluca Rigatelli, Francesco Caprioglio, Marco Zuin, Sara Giatti, Gabriele Braggion, Van Tan Nguyen, Federico Ronco |
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| Rok vydání: | 2018 |
| Předmět: |
Coronary angiography
Male medicine.medical_treatment Clinical Decision-Making Coronary Artery Disease 030204 cardiovascular system & hematology Coronary Angiography Prosthesis Design Severity of Illness Index 03 medical and health sciences 0302 clinical medicine Percutaneous Coronary Intervention Predictive Value of Tests Heart team Intravascular ultrasound Medicine Humans 030212 general & internal medicine General hospital Aged Retrospective Studies Aged 80 and over medicine.diagnostic_test business.industry Patient Selection Coronary Stenosis Stent General Medicine Middle Aged Coronary Vessels Vessel diameter Fractals Treatment Outcome Bypass surgery Italy Law Angiography Radiographic Image Interpretation Computer-Assisted Female Stents Cardiology and Cardiovascular Medicine business |
| Zdroj: | Cardiovascular revascularization medicine : including molecular interventions. 19(7 Pt) |
| ISSN: | 1878-0938 |
| Popis: | Intravascular ultrasound has been suggested to optimize stent diameter and length in Left Main (LM) procedures, but in the real-world ostial LM stenting is often accomplished with angiography only guidance. The Finet law which regulates the fractal geometry of human bifurcation has the potential to increase the accuracy of stent-sizing. To retrospectively evaluating the impact on outcomes of the addition of Finet Law to standard quantitative coronary angiography (QCA) in guiding stent selection of ostial LM stenting compared to standard angiography estimation.We retrospectively evaluated the clinical and instrumental records of patients with isolated ostial LM disease and bypass surgery contraindications or refusal as determined by the local Heart Team who received stenting from 1 January 2012 to 1 January 2017 at Rovigo General Hospital. Patients were discrimined on the basis of the addition to QCA angiographic evaluation of the Finet-law.Seventy-three patients (45 males, mean age 69.9 ± 10.9 years old) ostial LM stenting, 36 patients using QCA and Finet law (QCA-Finet) and 37 using standard QCA angiographic (QCA-angio) evaluation of the vessel diameter. By QCA, vessel size, mean stent diameter at implantation and after post-dilatation were clearly bigger in the QCA+ Finet than QCA-angio (4.4 ± 0.8 and 3.8 ± 0.7, p 0.001). At a mean follow-up of 5.0 ± 0.4 years, cardiovascular mortality and cardiovascular events incidence were higher in QCA-angio compared to QCA+Finet group of patients.Our study suggested that adding the Finet law to standard angiography estimation of the LM stent size may improve long-term outcomes. |
| Databáze: | OpenAIRE |
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