ABSTRACT
BACKGROUND: Optical coherence tomography (OCT) is reported to be a feasible and safe imaging modality for the guidance of percutaneous coronary intervention (PCI) of complex lesions. METHODS: This multicenter, prospective registry assessed the minimum stent area (MSA) achieved under OCT guidance. A performance goal of 24% improvement in MSA over and above the recommendation set by the European Association of Percutaneous Cardiovascular Interventions Consensus 2018 (4.5 mm2 MSA for non-left main and 3.5 mm2 for small vessels). The incidence of contrast-induced nephropathy was also assessed. Core lab analysis was conducted. RESULTS: Five hundred patients (average age: 59.4 ± 10.1 years; 83% males) with unstable angina (36.8%), NSTEMI (26.4%), and STEMI (22%) were enrolled. The primary endpoint was achieved in 93% of lesions with stent diameter ≥2.75 mm (average MSA: 6.44 mm2) and 87% of lesions with stent diameter ≤2.5 mm (average MSA: 4.56 mm2). The average MSA (with expansion ≥80% cutoff) was 6.63 mm2 and 4.74 mm2 with a stent diameter ≥2.75 mm and ≤2.5 mm, respectively. According to the core lab analysis, the average MSA achieved with a stent diameter ≥2.75 mm and ≤2.5 mm was 6.23 mm2 and 3.95 mm2, respectively (with expansion ≥80% cutoff). Clinically significant serum creatinine was noted in two patients (0.45%). Major adverse cardiac events at 1 year were noted in 1.2% (n = 6) of the patients; all were cardiac deaths. CONCLUSION: PCI under OCT guidance improves procedural and long-term clinical outcomes in patients with complex lesions not just in a controlled trial environment but also in routine clinical practice.
Subject(s)
Coronary Artery Disease , Percutaneous Coronary Intervention , Male , Humans , Middle Aged , Aged , Female , Tomography, Optical Coherence/methods , Coronary Angiography/methods , Percutaneous Coronary Intervention/methods , Treatment Outcome , Stents , Registries , Coronary Vessels , Coronary Artery Disease/diagnosis , Coronary Artery Disease/surgery , Coronary Artery Disease/etiologySubject(s)
Coronary Artery Disease/drug therapy , Fibrinolytic Agents/therapeutic use , Myocardial Infarction/drug therapy , Myocardial Reperfusion/methods , Thrombolytic Therapy/methods , Combined Modality Therapy , Coronary Artery Disease/diagnostic imaging , Coronary Artery Disease/mortality , Evidence-Based Medicine , Female , Fibrinolytic Agents/adverse effects , Hemorrhage/chemically induced , Hemorrhage/epidemiology , Humans , India , Male , Myocardial Infarction/diagnosis , Myocardial Infarction/mortality , Myocardial Infarction/therapy , Prognosis , Radiography , Randomized Controlled Trials as Topic , Risk Assessment , Role , Survival Analysis , Thrombolytic Therapy/adverse effects , Treatment OutcomeABSTRACT
Isolated iliac artery aneurysms (IIAAs) are rare. We present a patient with lumbosacral plexopathy due to common iliac artery aneurysm rupture that presented with left monoplegia.
