CBS 2019
CBSMD教育中心
中 文

Scientific Library

Abstract

Recommended Article

Intravascular ultrasound assessment of the effects of rotational atherectomy in calcified coronary artery lesions Effects of Intravascular Ultrasound-Guided Versus Angiography-Guided New-Generation Drug-Eluting Stent Implantation: Meta-Analysis With Individual Patient-Level Data From 2,345 Randomized Patients Optical Coherence Tomography Guided Percutaneous Coronary Intervention With Nobori Stent Implantation in Patients With Non-ST-Segment-Elevation Myocardial Infarction (OCTACS) Trial: Difference in Strut Coverage and Dynamic Malapposition Patterns at 6 Months Diagnosis and management of acute deep vein thrombosis: a joint consensus document from the European Society of Cardiology working groups of aorta and peripheral vascular diseases and pulmonary circulation and right ventricular function Value of Coronary Artery Calcium Scanning in Association With the Net Benefit of Aspirin in Primary Prevention of Atherosclerotic Cardiovascular Disease Intravascular Ultrasound Parameters Associated With Stent Thrombosis After Drug-Eluting Stent Deployment Impact of intravascular ultrasound guidance in routine percutaneous coronary intervention for conventional lesions: data from the EXCELLENT trial Comparison of paclitaxel-eluting stents (Taxus) and everolimus-eluting stents (Xience) in left main coronary artery disease with 3 years follow-up (from the ESTROFA-LM registry)

Original Research2018 Sep;34(9):1365-1371.

JOURNAL:Int J Cardiovasc Imaging. Article Link

Intravascular ultrasound assessment of the effects of rotational atherectomy in calcified coronary artery lesions

Kim SS, Yamamoto MH, Maehara A et al. Keywords: Calcified lesions; Intravascular ultrasound; Rotational atherectomy

ABSTRACT


We sought to clarify intravascular ultrasound (IVUS) features of rotational atherectomy (RA) of calcified lesions. IVUS was performed post-RA and post-stent in 38 lesions and analyzed every 1 mm. Pre-intervention IVUS was performed when the IVUS catheter crossed the lesion (n = 11). Calcium Index was average calcium angle multiplied by calcium length. We compared lowest (n = 13), middle (n = 13), and highest (n = 12) Calcium Index tertiles. Reverberations (multiple reflections from calcium) with a concave-shaped lumen in the post-RA IVUS were considered to represent RA-related calcium modification. Newly visible perivascular tissue through a previously solid arc of calcium in the post-stent IVUS was also evaluated. Comparing the pre and post-RA IVUS, maximum reverberation angle, and length increased significantly after RA (angle, from 45° [31, 67] to 96° [50, 148], p = 0.003; length, from 4.0 mm [2.0, 6.0] to 8.0 mm [4.0, 14.0], p = 0.005). In the post-RA IVUS, reverberations had a larger angle in the middle and highest Calcium Index tertiles (lowest, 91° [64, 133]; middle, 135° [107, 201]; highest, 150° [93, 208], p = 0.03). Post-stent newly visible perivascular tissue was more frequent in the middle and highest Calcium Index tertiles (lowest, 30.8%; middle, 69.2%; highest, 75.0%, p = 0.049). Minimum stent area was similar after calcium modification by RA irrespective of the severity of the Calcium Index (lowest, 6.7 mm2 [5.7, 8.9]; middle, 5.6 mm2 [4.9, 6.8]; highest, 6.7 mm2 [5.9, 8.2], p = 0.2). Greater calcium modification by RA occurs in severely calcified lesions with smaller lumen diameters to mitigate against stent underexpansion.