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Reasons for lesion uncrossability as assessed by intravascular ultrasound.
Salem, Hanan; Mintz, Gary S; Matsumura, Mitsuaki; Zhang, Mingyou; Usui, Eisuke; Seike, Fumiyasu; Fujimura, Tatsuhiro; Noguchi, Masahiko; Hu, Xun; Jin, Ge; Li, Chenguang; Fall, Khady N; Ali, Ziad A; Kirtane, Ajay J; Collins, Michael B; Kodali, Susheel K; Nazif, Tamim M; Leon, Martin B; Moses, Jeffrey W; Karmpaliotis, Dimitri; Maehara, Akiko.
Afiliación
  • Salem H; Clinical Trials Center, Cardiovascular Research Foundation, New York, New York, USA.
  • Mintz GS; Division of Cardiovascular Medicine, New York-Presbyterian Hospita, Columbia University Irving Medical Center, New York, New York, USA.
  • Matsumura M; Cardiovascular Medicine Department, Tanta University Hospitals, Faculty of Medicine - Tanta University, Tanta, Egypt.
  • Zhang M; Clinical Trials Center, Cardiovascular Research Foundation, New York, New York, USA.
  • Usui E; Clinical Trials Center, Cardiovascular Research Foundation, New York, New York, USA.
  • Seike F; Clinical Trials Center, Cardiovascular Research Foundation, New York, New York, USA.
  • Fujimura T; Division of Cardiovascular Medicine, New York-Presbyterian Hospita, Columbia University Irving Medical Center, New York, New York, USA.
  • Noguchi M; Clinical Trials Center, Cardiovascular Research Foundation, New York, New York, USA.
  • Hu X; Division of Cardiovascular Medicine, New York-Presbyterian Hospita, Columbia University Irving Medical Center, New York, New York, USA.
  • Jin G; Clinical Trials Center, Cardiovascular Research Foundation, New York, New York, USA.
  • Li C; Division of Cardiovascular Medicine, New York-Presbyterian Hospita, Columbia University Irving Medical Center, New York, New York, USA.
  • Fall KN; Clinical Trials Center, Cardiovascular Research Foundation, New York, New York, USA.
  • Ali ZA; Division of Cardiovascular Medicine, New York-Presbyterian Hospita, Columbia University Irving Medical Center, New York, New York, USA.
  • Kirtane AJ; Clinical Trials Center, Cardiovascular Research Foundation, New York, New York, USA.
  • Collins MB; Division of Cardiovascular Medicine, New York-Presbyterian Hospita, Columbia University Irving Medical Center, New York, New York, USA.
  • Kodali SK; Clinical Trials Center, Cardiovascular Research Foundation, New York, New York, USA.
  • Nazif TM; Division of Cardiovascular Medicine, New York-Presbyterian Hospita, Columbia University Irving Medical Center, New York, New York, USA.
  • Leon MB; Clinical Trials Center, Cardiovascular Research Foundation, New York, New York, USA.
  • Moses JW; Division of Cardiovascular Medicine, New York-Presbyterian Hospita, Columbia University Irving Medical Center, New York, New York, USA.
  • Karmpaliotis D; Clinical Trials Center, Cardiovascular Research Foundation, New York, New York, USA.
  • Maehara A; Division of Cardiovascular Medicine, New York-Presbyterian Hospita, Columbia University Irving Medical Center, New York, New York, USA.
Catheter Cardiovasc Interv ; 99(7): 2028-2037, 2022 06.
Article en En | MEDLINE | ID: mdl-35419936
OBJECTIVES: The purpose of the current study was to use intravascular ultrasound (IVUS) to clarify anatomical and morphological lesion characteristics of uncrossable lesions. BACKGROUND: Uncrossable lesions are not always severely calcified. The prevalence of uncrossable lesions that are nonseverely calcified as well as other mechanisms for uncrossability has not been well clarified. METHODS: A total of 252 de novo uncrossable lesions in native coronary arteries that underwent either rotational or orbital atherectomy due to inability of any balloon to cross the lesion and 38 lesions with severe calcium in which IVUS crossed preatherectomy were included. Severe calcium is defined as maximum arc of calcium ≥270°. RESULTS: Severe calcification was absent in 16% of uncrossable lesions, 83% of which had a significant vessel bend. Compared with crossable lesions with severe calcium, uncrossable lesions with severe calcium more often had a bend in the vessel (71% vs. 21%, p < 0.001) and a longer length of continuous severe calcium (median length of calcium ≥270° 3.8 mm vs. 1.9 mm, p = 0.001). Other than severe calcium (especially long continuous calcium) or a bend in the vessel, anatomical factors associated with uncrossabilty were aorto-ostial lesion location and small vessels. CONCLUSIONS: Uncrossable lesions are not always severely calcified. The interaction of lesion morphology (continuous long and large arcs of calcium) and vessel geometry (bend in the vessel or ostial lesion location) affect lesion crossability.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedad de la Arteria Coronaria / Aterectomía Coronaria / Calcificación Vascular Tipo de estudio: Risk_factors_studies Límite: Humans Idioma: En Revista: Catheter Cardiovasc Interv Asunto de la revista: CARDIOLOGIA Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedad de la Arteria Coronaria / Aterectomía Coronaria / Calcificación Vascular Tipo de estudio: Risk_factors_studies Límite: Humans Idioma: En Revista: Catheter Cardiovasc Interv Asunto de la revista: CARDIOLOGIA Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos