Imaging Characteristics of Mismatch Lesions: An Angiographic and Intravascular Ultrasound Analysis of 1369 Coronary Lesions
| Autor: | Lan Viet Nguyen, Iksung Cho, Tan Quang Phan, Lan Hieu Nguyen, Hoyoun Won, Julian Johny Thottian, Sang Wook Kim, Wang Soo Lee, Seung Yong Shin, Saima Sharmin |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_treatment Lumen (anatomy) Coronary Artery Disease 030204 cardiovascular system & hematology Coronary Angiography Lesion 03 medical and health sciences Percutaneous Coronary Intervention 0302 clinical medicine Predictive Value of Tests Intravascular ultrasound Humans Medicine 030212 general & internal medicine Ultrasonography Interventional Aged medicine.diagnostic_test business.industry Coronary Stenosis Percutaneous coronary intervention Heart Middle Aged Coronary Vessels Confidence interval Conventional PCI Angiography Female medicine.symptom Cardiology and Cardiovascular Medicine business Nuclear medicine TIMI |
| Zdroj: | Angiology. 70:756-764 |
| ISSN: | 1940-1574 0003-3197 |
| DOI: | 10.1177/0003319718822348 |
| Popis: | Objectives:To evaluate the angiographic and intravascular ultrasound (IVUS) characteristics of coronary mismatch lesions.Background:Better understanding about the characteristics of mismatch lesions may help to achieve more accurate lesion assessment and, thereby, to improve the outcomes of percutaneous coronary intervention (PCI).Methods:Angiographic and IVUS data from 1369 lesions were analyzed. Mismatch lesion was defined as the difference between proximal and distal reference lumen diameters of ≥1.0 mm or ≥30% of the distal reference lumen diameter.Results:The incidence of mismatch lesions was 20.1% (275/1369). Compared to nonmismatch group, mismatch group had longer lesions (21.3 [6.4] mm vs 18.4 [6.4] mm, P < .001) with smaller minimum lumen diameter (0.87 [0.29] mm vs 1.10 [0.31] mm, P < .001) and more severe diameter stenosis (78.8% [9.2%] vs 66.3% [10.3%], P < .001). On IVUS, mismatch group had larger lumen area (18.7 [5.0] vs 15.8 [5.1] mm2, P < .001) but lower plaque burden at the proximal reference segment (41.0% [9.2%] vs 45.7% [9.9%], P < .001) and smaller lumen area (4.83 [1.89] vs 7.36 [2.89] mm, P < .001) but higher plaque burden at the distal reference segment (42.9% [10.4%] vs 41.4% [10.1%], P = .023). Multivariable logistic regression analysis showed that mismatch lesions were frequently accompanied by diffuse lesions (odds ratio [OR] = 2.50; 95% confidence interval [CI]: 1.83-3.40; P < .001), bifurcation lesions (OR = 5.83; 95% CI: 4.40-7.74; P < .001), and lesions with a low TIMI flow grade (OR = 1.70; 95% CI: 1.08-2.67; P = .022) or severe diameter stenosis (OR = 3.05; 95% CI: 2.10-4.43; P < .001).Conclusions:Mismatch lesions are quite common and characterized by greater lesion complexity compared with nonmismatch lesions. Further studies may be necessary to address the impact of this lesion type on the outcome of PCI. |
| Databáze: | OpenAIRE |
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