Optical frequency-domain imaging findings to predict good stent expansion after rotational atherectomy for severely calcified coronary lesions View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2018-01-09

AUTHORS

Norihiro Kobayashi, Yoshiaki Ito, Masahiro Yamawaki, Motoharu Araki, Tsuyoshi Sakai, Yasunari Sakamoto, Shinsuke Mori, Masakazu Tsutsumi, Masahiro Nauchi, Yohsuke Honda, Takahiro Tokuda, Kenji Makino, Shigemitsu Shirai, Keisuke Hirano

ABSTRACT

We aimed to evaluate the optical frequency-domain imaging (OFDI) findings after rotational atherectomy (RA) that predict good stent expansion for severely calcified coronary lesions. Fifty consecutive calcified lesions were subjected to RA under OFDI guidance. We performed OFDI just after RA and stenting. We measured the morphology of calcium after RA, and assessed how these factors influence stent expansion. The stent expansion index was defined as the minimum stent area divided by the average of the proximal and distal reference lumen areas. Minimum thickness of calcification in the intima after RA showed a significant negative correlation with stent expansion (r = − 0.53, P < 0.001), while calcium arc, length, and maximum thickness of calcification in the intima did not. Dissection after RA occurred in 22 lesions (44%), and the stent expansion index was significantly better in dissected lesions than in lesions without dissection (0.96 ± 0.08 vs. 0.82 ± 0.19, P = 0.002). Multiple regression analysis showed that the minimum thickness of calcification in the intima (standardized coefficient: − 0.451, P < 0.001) and dissection formation (standardized coefficient: 0.316, P = 0.011) were predictors of good stent expansion. Minimum of thickness of calcification in the intima and dissection formation were positively associated with good stent expansion after RA. In the clinical setting, achieving these two endpoints should be the aim of RA to ensure good stent expansion. More... »

PAGES

867-874

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s10554-018-1300-x

DOI

http://dx.doi.org/10.1007/s10554-018-1300-x

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1100268237

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/29318407


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21 schema:description We aimed to evaluate the optical frequency-domain imaging (OFDI) findings after rotational atherectomy (RA) that predict good stent expansion for severely calcified coronary lesions. Fifty consecutive calcified lesions were subjected to RA under OFDI guidance. We performed OFDI just after RA and stenting. We measured the morphology of calcium after RA, and assessed how these factors influence stent expansion. The stent expansion index was defined as the minimum stent area divided by the average of the proximal and distal reference lumen areas. Minimum thickness of calcification in the intima after RA showed a significant negative correlation with stent expansion (r = − 0.53, P < 0.001), while calcium arc, length, and maximum thickness of calcification in the intima did not. Dissection after RA occurred in 22 lesions (44%), and the stent expansion index was significantly better in dissected lesions than in lesions without dissection (0.96 ± 0.08 vs. 0.82 ± 0.19, P = 0.002). Multiple regression analysis showed that the minimum thickness of calcification in the intima (standardized coefficient: − 0.451, P < 0.001) and dissection formation (standardized coefficient: 0.316, P = 0.011) were predictors of good stent expansion. Minimum of thickness of calcification in the intima and dissection formation were positively associated with good stent expansion after RA. In the clinical setting, achieving these two endpoints should be the aim of RA to ensure good stent expansion.
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28 aim
29 analysis
30 arc
31 area
32 atherectomy
33 average
34 calcification
35 calcium
36 calcium arc
37 clinical setting
38 coronary lesions
39 correlation
40 dissection
41 dissection formation
42 distal reference lumen area
43 endpoint
44 expansion
45 expansion index
46 factors
47 findings
48 formation
49 good stent expansion
50 guidance
51 imaging findings
52 index
53 intima
54 length
55 lesions
56 lumen area
57 maximum thickness
58 minimum
59 minimum stent area
60 minimum thickness
61 morphology
62 morphology of calcium
63 multiple regression analysis
64 negative correlation
65 predictors
66 reference lumen area
67 regression analysis
68 rotational atherectomy
69 setting
70 significant negative correlation
71 stent area
72 stent expansion
73 stent expansion index
74 stenting
75 thickness
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