Immediate results of bifurcational stenting assessed with optical coherence tomography

Nicola Viceconte, Pawel Tyczynski, Giuseppe Ferrante, Nicolas Foin, Pak Hei Chan, Eduardo Alegrìa Barrero, Carlo Di Mario

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Background: A tubular stent may adapt with difficulty to coronary bifurcation lesions (CBLs). Methods: Time domain or frequency domain (FD) optical coherence tomography (OCT) was performed to assess strut apposition immediately after stent implantation across four segments inside the bifurcation, in a consecutive series of patients. OCT pullbacks were performed in the main vessel (MV). Results: A total of 13,142 struts in 45 CBL in 41 patients were assessed. Strut malapposition was significantly more frequent in the half bifurcation facing the side-branch (SB) ostium (42.9%) than in the proximal segment of the bifurcation 11.8%, half bifurcation opposite the SB 6.7%, or the distal segment 5.7% (all P <0.0001). Lesions (n = 15) treated with stenting of both MV and SB had a total higher rate of malapposition than those (n = 30) treated with stenting of the MV only (17.6% vs. 9.5%; P = 0.0014). In latter group, lesions treated with FD-OCT-guided stent implantation (n = 13) presented a lower rate of malapposition than those treated with conventional angiographic-guided stent implantation (n = 17) (7.1% vs. 17.5%; P = 0.005). Conclusions: In CBL, strut malapposition is particularly high at the SB ostium. However, a strategy of stenting MV only with adjunctive FD-OCT guidance is associated with lower rates of malapposition.

Original languageEnglish
Pages (from-to)519-528
Number of pages10
JournalCatheterization and Cardiovascular Interventions
Volume81
Issue number3
DOIs
Publication statusPublished - Feb 2013

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Optical Coherence Tomography
Stents

Keywords

  • bifurcations
  • lesion assessment
  • optical coherence tomography
  • percutaneous coronary intervention
  • stent optimization

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

Immediate results of bifurcational stenting assessed with optical coherence tomography. / Viceconte, Nicola; Tyczynski, Pawel; Ferrante, Giuseppe; Foin, Nicolas; Chan, Pak Hei; Barrero, Eduardo Alegrìa; Di Mario, Carlo.

In: Catheterization and Cardiovascular Interventions, Vol. 81, No. 3, 02.2013, p. 519-528.

Research output: Contribution to journalArticle

Viceconte, Nicola ; Tyczynski, Pawel ; Ferrante, Giuseppe ; Foin, Nicolas ; Chan, Pak Hei ; Barrero, Eduardo Alegrìa ; Di Mario, Carlo. / Immediate results of bifurcational stenting assessed with optical coherence tomography. In: Catheterization and Cardiovascular Interventions. 2013 ; Vol. 81, No. 3. pp. 519-528.
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abstract = "Background: A tubular stent may adapt with difficulty to coronary bifurcation lesions (CBLs). Methods: Time domain or frequency domain (FD) optical coherence tomography (OCT) was performed to assess strut apposition immediately after stent implantation across four segments inside the bifurcation, in a consecutive series of patients. OCT pullbacks were performed in the main vessel (MV). Results: A total of 13,142 struts in 45 CBL in 41 patients were assessed. Strut malapposition was significantly more frequent in the half bifurcation facing the side-branch (SB) ostium (42.9{\%}) than in the proximal segment of the bifurcation 11.8{\%}, half bifurcation opposite the SB 6.7{\%}, or the distal segment 5.7{\%} (all P <0.0001). Lesions (n = 15) treated with stenting of both MV and SB had a total higher rate of malapposition than those (n = 30) treated with stenting of the MV only (17.6{\%} vs. 9.5{\%}; P = 0.0014). In latter group, lesions treated with FD-OCT-guided stent implantation (n = 13) presented a lower rate of malapposition than those treated with conventional angiographic-guided stent implantation (n = 17) (7.1{\%} vs. 17.5{\%}; P = 0.005). Conclusions: In CBL, strut malapposition is particularly high at the SB ostium. However, a strategy of stenting MV only with adjunctive FD-OCT guidance is associated with lower rates of malapposition.",
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AU - Barrero, Eduardo Alegrìa

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N2 - Background: A tubular stent may adapt with difficulty to coronary bifurcation lesions (CBLs). Methods: Time domain or frequency domain (FD) optical coherence tomography (OCT) was performed to assess strut apposition immediately after stent implantation across four segments inside the bifurcation, in a consecutive series of patients. OCT pullbacks were performed in the main vessel (MV). Results: A total of 13,142 struts in 45 CBL in 41 patients were assessed. Strut malapposition was significantly more frequent in the half bifurcation facing the side-branch (SB) ostium (42.9%) than in the proximal segment of the bifurcation 11.8%, half bifurcation opposite the SB 6.7%, or the distal segment 5.7% (all P <0.0001). Lesions (n = 15) treated with stenting of both MV and SB had a total higher rate of malapposition than those (n = 30) treated with stenting of the MV only (17.6% vs. 9.5%; P = 0.0014). In latter group, lesions treated with FD-OCT-guided stent implantation (n = 13) presented a lower rate of malapposition than those treated with conventional angiographic-guided stent implantation (n = 17) (7.1% vs. 17.5%; P = 0.005). Conclusions: In CBL, strut malapposition is particularly high at the SB ostium. However, a strategy of stenting MV only with adjunctive FD-OCT guidance is associated with lower rates of malapposition.

AB - Background: A tubular stent may adapt with difficulty to coronary bifurcation lesions (CBLs). Methods: Time domain or frequency domain (FD) optical coherence tomography (OCT) was performed to assess strut apposition immediately after stent implantation across four segments inside the bifurcation, in a consecutive series of patients. OCT pullbacks were performed in the main vessel (MV). Results: A total of 13,142 struts in 45 CBL in 41 patients were assessed. Strut malapposition was significantly more frequent in the half bifurcation facing the side-branch (SB) ostium (42.9%) than in the proximal segment of the bifurcation 11.8%, half bifurcation opposite the SB 6.7%, or the distal segment 5.7% (all P <0.0001). Lesions (n = 15) treated with stenting of both MV and SB had a total higher rate of malapposition than those (n = 30) treated with stenting of the MV only (17.6% vs. 9.5%; P = 0.0014). In latter group, lesions treated with FD-OCT-guided stent implantation (n = 13) presented a lower rate of malapposition than those treated with conventional angiographic-guided stent implantation (n = 17) (7.1% vs. 17.5%; P = 0.005). Conclusions: In CBL, strut malapposition is particularly high at the SB ostium. However, a strategy of stenting MV only with adjunctive FD-OCT guidance is associated with lower rates of malapposition.

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