Serial intravascular ultrasound analysis comparing double kissing and classical crush stenting for coronary bifurcation lesions.
Catheter Cardiovasc Interv
; 78(5): 729-36, 2011 Nov 01.
Article
em En
| MEDLINE
| ID: mdl-21538789
ABSTRACT
BACKGROUND:
Compared with the classical crush, double kissing (DK) crush improved outcomes in patients with coronary bifurcation lesions. However, there is no serial intravascular ultrasound (IVUS) comparisons between these two techniques.OBJECTIVES:
This study aimed to analyze the mechanisms of the two crush stenting techniques using serial IVUS imaging.METHODS:
A total of 54 patients with IVUS images at baseline, post-stenting and eight-month follow-up were classified into classical (n = 16) and DK (n = 38) groups. All patients underwent final kissing balloon inflation (FKBI). Unsatisfactory kissing (KUS) was defined as the presence of wrist or >20% stenosis during FKBI at the side branch (SB) ostium. The vessels at bifurcation lesions were divided into the proximal main vessel (MV) stent, the crushed segment, the distal MV stent, the SB ostium and the SB stent body.RESULTS:
KUS and incomplete crushing were commonly observed in the classical group (62.5%, 81.3%), compared with DK group (18.0%, 39.5%, P < 0.001 and P = 0.004). The post-stenting stent symmetry in the classical group was 71.85 ± 7.69% relative to 85.93 ± 6.09% in DK group (P = 0.022), resulting in significant differences in neointimal hyperplasia (NIH, 1.60 ± 0.21 mm(2) vs. 0.85 ± 0.23 mm(2) , P = 0.005), late lumen loss (1.31 ± 0.81 mm(2) vs. 0.55 ± 0.70 mm(2) , P = 0.013), and minimal lumen area (MLA, 3.57 ± 1.52 mm(2) vs. 4.52 ± 1.40 mm(2,) P = 0.042) at the SB ostium between two groups. KUS was positively correlated with the incomplete crush and was the only predictor of in-stent-restenosis (ISR) at the SB ostium.CONCLUSION:
DK crush was associated with improved quality of the FKBI and larger MLA. KUS predicted the occurrence of ISR.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Doença da Artéria Coronariana
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Angioplastia Coronária com Balão
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Ultrassonografia de Intervenção
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Reestenose Coronária
Tipo de estudo:
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
/
Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Ano de publicação:
2011
Tipo de documento:
Article