Predictors of ostial side branch damage during provisional stenting of coronary bifurcation lesions not involving the side branch origin: an ultrasonographic study.
EuroIntervention
; 7(10): 1147-54, 2012 Feb.
Article
en En
| MEDLINE
| ID: mdl-22030298
AIMS: To analyse the ultrasound anatomy of bifurcation lesions {1,1,0},{0,1,0} and {1,0,0} of the Medina classification in order to identify predictors of angiographic side branch (SB) damage after main branch (MB) stenting. METHODS AND RESULTS: One hundred and ten patients with Medina classification bifurcation lesions of {1,1,0},{0,1,0} and {1,0,0} were recruited. An intravascular ultrasound study (IVUS) was performed on the MB before treatment, after stent implantation and after SB intervention. A quantitative analysis was conducted in combination with a qualitative study of the carina morphology and plaque distribution. Ostial SB damage (an increase of the percentage of ostial stenosis by QCA ≥30%) was observed in 51 lesions (48%) after MB stenting. The baseline IVUS identified a carina with a spiky morphology ("eyebrow" sign) in 51 bifurcations. In 41 out of 51 bifurcations with this sign, ostial SB damage was induced after stenting the MB due to carina shift (p<0.01). Narrower angiographic angles were associated with the presence of the "eyebrow" sign (62º±23º vs. 76º±24º, p<0.05). Plaque located at the carina was associated with a lower rate of ostial SB damage (29%) when compared with those lesions with no plaque exhibiting at the carina (51%), p<0.05. CONCLUSIONS: The "eyebrow" sign is a powerful predictor of ostial SB damage after stent implantation in the MB in bifurcation coronary lesions without plaque involving the SB.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Enfermedad de la Arteria Coronaria
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Angioplastia Coronaria con Balón
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Stents
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Anomalías de los Vasos Coronarios
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Vasos Coronarios
Tipo de estudio:
Observational_studies
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Prognostic_studies
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Qualitative_research
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Risk_factors_studies
Límite:
Aged
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Female
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Humans
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Male
/
Middle aged
Idioma:
En
Revista:
EuroIntervention
Asunto de la revista:
ANGIOLOGIA
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CARDIOLOGIA
/
TERAPEUTICA
Año:
2012
Tipo del documento:
Article
País de afiliación:
España
Pais de publicación:
Francia