Simple Versus Complex Approaches to Treating Coronary Bifurcation Lesions: Direct Assessment of Stent Strut Apposition by Optical Coherence Tomography
| Autor: | Elio Pieri, Kevin J. Beatt, Carlo Di Mario, Neville Kukreja, Paweł Tyczyński, Peter Barlis, Giuseppe Ferrante, Ranil de Silva, Cristina Moreno-Ambroj |
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| Rok vydání: | 2010 |
| Předmět: |
Male
medicine.medical_specialty Direct assessment medicine.medical_treatment Coronary Artery Disease Prosthesis Implantation Optical coherence tomography Interquartile range medicine Humans cardiovascular diseases Coronary bifurcation Aged medicine.diagnostic_test business.industry Stent Percutaneous coronary intervention General Medicine Middle Aged equipment and supplies Apposition Ostium surgical procedures operative cardiovascular system Female Stents Radiology business Tomography Optical Coherence |
| Zdroj: | Revista Española de Cardiología (English Edition). 63:904-914 |
| ISSN: | 1885-5857 |
| DOI: | 10.1016/s1885-5857(10)70184-5 |
| Popis: | Introduction and objectives. Stenting of coronary bifurcation lesions carries an increased risk of stent deformation and malapposition. Anatomical and pathological observations indicate that the high stent thrombosis rate in bifurcations is due to malapposition of stent struts. Methods. Strut apposition was assessed with optical coherence tomography (OCT) in bifurcation lesions treated either using the simple technique of stent implantation in the main vessel only or a complex technique (i.e. Culotte’s). A strut was regarded as malapposed if the gap between its endoluminal surface and the vessel wall was greater than its thickness plus an OCT resolution error margin of 15 µm. Results. Simple and complex (i.e. Culotte’s) approaches were used in 17 and 14 patients, respectively. Strut malapposition was significantly more frequent for the half of the bifurcation on the same side as the vessel side branch (median, 46.1%; interquartile range [IQR], 35.3–62.5%) than for the half opposite the side branch (9.1%; IQR, 2.2–21.6%), the distal segment (7.5%; IQR, 2.3–20.2%) or the proximal segment (12.6%; IQR, 7.8– 23.1%; P |
| Databáze: | OpenAIRE |
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