The Relation Between Optical Coherence Tomography-Detected Layered Pattern and Acute Side Branch Occlusion after Provisional Stenting of Coronary Bifurcation Lesions.
Aged
Coronary Angiography
Coronary Artery Disease
/ diagnostic imaging
Coronary Occlusion
/ diagnostic imaging
Coronary Vessels
/ diagnostic imaging
Female
Humans
Male
Middle Aged
Percutaneous Coronary Intervention
/ adverse effects
Predictive Value of Tests
Retrospective Studies
Risk Factors
Stents
Time Factors
Tomography, Optical Coherence
Treatment Outcome
Ultrasonography, Interventional
Bifurcation
Coronary plaque
Optical coherence tomography
Side branch
Stent
Journal
Cardiovascular revascularization medicine : including molecular interventions
ISSN: 1878-0938
Titre abrégé: Cardiovasc Revasc Med
Pays: United States
ID NLM: 101238551
Informations de publication
Date de publication:
11 2019
11 2019
Historique:
received:
31
08
2018
revised:
12
12
2018
accepted:
21
12
2018
pubmed:
27
1
2019
medline:
23
6
2020
entrez:
27
1
2019
Statut:
ppublish
Résumé
Layered pattern (presumed to be healed plaque after a thrombotic event) can be observed by optical coherence tomography (OCT). We sought to assess the ability of OCT-detected plaque composition to predict acute side branch (SB) occlusion after provisional bifurcation stenting. This is a retrospective observational study using pre-intervention OCT in the main vessel to predict Thrombolysis in Myocardial Infarction (TIMI) flow grade ≤1 in a SB (diameter ≥ 1.5 mm) after provisional bifurcation stenting. OCT-detected layered pattern was defined as plaque with a superficial layer that had a different optical intensity and a clear demarcation from underlying tissue. Overall, 207 patients with stable coronary disease were included. SB occlusion occurred in 26/207 (12.6%) bifurcation lesions. Operators decided not to perform additional treatment, and TIMI flow did not improve to ≥2 in cases with SB occlusion. The prevalence of OCT-detected layered pattern was more common in lesions with versus without SB occlusion (88.5% versus 33.7%, p < 0.0001); OCT-detected layered pattern was more often located on the same side of the SB (73.9% versus 21.3%, p < 0.0001) circumferentially compared to lesions without SB occlusion. Multivariable analysis showed that OCT-detected layered pattern was an independent predictor of SB occlusion (odds ratio 18.8, 95% confidence interval 5.1-68.8, p < 0.0001) along with true bifurcation lesion and wider angiographic bifurcation angle. The presence of an OCT-detected layered pattern near its ostium was a strong predictor of SB occlusion after provisional bifurcation stenting.
Sections du résumé
BACKGROUND/PURPOSE
Layered pattern (presumed to be healed plaque after a thrombotic event) can be observed by optical coherence tomography (OCT). We sought to assess the ability of OCT-detected plaque composition to predict acute side branch (SB) occlusion after provisional bifurcation stenting.
METHODS
This is a retrospective observational study using pre-intervention OCT in the main vessel to predict Thrombolysis in Myocardial Infarction (TIMI) flow grade ≤1 in a SB (diameter ≥ 1.5 mm) after provisional bifurcation stenting. OCT-detected layered pattern was defined as plaque with a superficial layer that had a different optical intensity and a clear demarcation from underlying tissue.
RESULTS
Overall, 207 patients with stable coronary disease were included. SB occlusion occurred in 26/207 (12.6%) bifurcation lesions. Operators decided not to perform additional treatment, and TIMI flow did not improve to ≥2 in cases with SB occlusion. The prevalence of OCT-detected layered pattern was more common in lesions with versus without SB occlusion (88.5% versus 33.7%, p < 0.0001); OCT-detected layered pattern was more often located on the same side of the SB (73.9% versus 21.3%, p < 0.0001) circumferentially compared to lesions without SB occlusion. Multivariable analysis showed that OCT-detected layered pattern was an independent predictor of SB occlusion (odds ratio 18.8, 95% confidence interval 5.1-68.8, p < 0.0001) along with true bifurcation lesion and wider angiographic bifurcation angle.
CONCLUSIONS
The presence of an OCT-detected layered pattern near its ostium was a strong predictor of SB occlusion after provisional bifurcation stenting.
Identifiants
pubmed: 30683562
pii: S1553-8389(18)30624-9
doi: 10.1016/j.carrev.2018.12.021
pii:
doi:
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
1007-1013Informations de copyright
Copyright © 2018 Elsevier Inc. All rights reserved.