TY - JOUR
T1 - Calcification analysis by intravascular ultrasound to define a predictor of left circumflex narrowing after cross-over stenting for unprotected left main bifurcation lesions
AU - Sato, Kastsumasa
AU - Naganuma, Toru
AU - Costopoulos, Charis
AU - Takebayashi, Hideo
AU - Goto, Kenji
AU - Miyazaki, Tadashi
AU - Yamane, Hiroki
AU - Hagikura, Arata
AU - Kikuta, Yuetsu
AU - Taniguchi, Masahito
AU - Hiramatsu, Shigeki
AU - Latib, Azeem
AU - Ito, Hiroshi
AU - Haruta, Seiichi
AU - Colombo, Antonio
PY - 2014/3
Y1 - 2014/3
N2 - Objectives: The aim of this study was to identify predictors of significant LCx-ostium compromise after distal unprotected left main coronary artery (ULMCA) stenting on the basis of baseline intravascular ultrasound (IVUS). Background: Provisional single-stenting is considered as the default strategy for non-true bifurcation lesions in ULMCA. However, in certain cases, left circumflex artery (LCx)-ostium stenting is necessary. Methods: A total of 77 patients underwent percutaneous coronary intervention with drug-eluting stents for non-true bifurcation lesions in ULMCA and had IVUS evaluation. Pre-procedural IVUS was performed to measure cross-sectional areas at the following segments: left main trunk, left anterior descending artery (LAD)-ostium. Post-stenting-narrowing at the circumflex ostium (PSN-LCx) was defined as the presence of more than 50% diameter stenosis at the LCx-ostium as determined by quantitative coronary angiography analysis. Results: PSN-LCx occurred in 27 (35%) patients. The presence of calcified plaque at the culprit lesion as identified by IVUS was more frequently observed in the PSN-LCx group as compared to the non-PSN-LCx group (81.5% vs. 22.0%, p. <. 0.001). Calcium arc in the PSN-LCx group was significantly greater than that in the non-PSN-LCx group (118.1°. ±. 69.9° vs. 36.9°. ±. 63.0°, p. <. 0.001). On multivariable analysis, a calcium arc. >. 60° was an independent predictor of PSN-LCx (odds ratio: 5.12, 95% confidence interval: 1.21-25.01, p. = 0.03). Conclusions: The presence of calcified plaque at the culprit lesion appears to be one of the factors involved in LCx-ostial compromise in non-true bifurcation ULMCA lesions, especially when the calcium arc is >. 60°.
AB - Objectives: The aim of this study was to identify predictors of significant LCx-ostium compromise after distal unprotected left main coronary artery (ULMCA) stenting on the basis of baseline intravascular ultrasound (IVUS). Background: Provisional single-stenting is considered as the default strategy for non-true bifurcation lesions in ULMCA. However, in certain cases, left circumflex artery (LCx)-ostium stenting is necessary. Methods: A total of 77 patients underwent percutaneous coronary intervention with drug-eluting stents for non-true bifurcation lesions in ULMCA and had IVUS evaluation. Pre-procedural IVUS was performed to measure cross-sectional areas at the following segments: left main trunk, left anterior descending artery (LAD)-ostium. Post-stenting-narrowing at the circumflex ostium (PSN-LCx) was defined as the presence of more than 50% diameter stenosis at the LCx-ostium as determined by quantitative coronary angiography analysis. Results: PSN-LCx occurred in 27 (35%) patients. The presence of calcified plaque at the culprit lesion as identified by IVUS was more frequently observed in the PSN-LCx group as compared to the non-PSN-LCx group (81.5% vs. 22.0%, p. <. 0.001). Calcium arc in the PSN-LCx group was significantly greater than that in the non-PSN-LCx group (118.1°. ±. 69.9° vs. 36.9°. ±. 63.0°, p. <. 0.001). On multivariable analysis, a calcium arc. >. 60° was an independent predictor of PSN-LCx (odds ratio: 5.12, 95% confidence interval: 1.21-25.01, p. = 0.03). Conclusions: The presence of calcified plaque at the culprit lesion appears to be one of the factors involved in LCx-ostial compromise in non-true bifurcation ULMCA lesions, especially when the calcium arc is >. 60°.
KW - Bifurcation
KW - Intravascular ultrasound
KW - Left main coronary artery stenosis
KW - Plaque morphology
UR - https://www.scopus.com/pages/publications/84896926444
UR - https://www.scopus.com/pages/publications/84896926444#tab=citedBy
U2 - 10.1016/j.carrev.2014.01.014
DO - 10.1016/j.carrev.2014.01.014
M3 - Article
C2 - 24684758
AN - SCOPUS:84896926444
SN - 1553-8389
VL - 15
SP - 80
EP - 85
JO - Cardiovascular Revascularization Medicine
JF - Cardiovascular Revascularization Medicine
IS - 2
ER -