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The Role of Vascular Imaging in Guiding Routine Percutaneous Coronary Interventions: A Meta-Analysis of Bare Metal Stent and Drug-Eluting Stent Trials Imaging- and physiology-guided percutaneous coronary intervention without contrast administration in advanced renal failure: a feasibility, safety, and outcome study The relationship between attenuated plaque identified by intravascular ultrasound and no-reflow after stenting in acute myocardial infarction: the HORIZONS-AMI (Harmonizing Outcomes With Revascularization and Stents in Acute Myocardial Infarction) trial Comparison of one-year clinical outcomes between intravascular ultrasound-guided versus angiography-guided implantation of drug-eluting stents for left main lesions: a single-center analysis of a 1,016-patient cohort Consensus from the 5th European Bifurcation Club meeting Intravascular ultrasound-guided systematic two-stent techniques for coronary bifurcation lesions and reduced late stent thrombosis Mechanisms of in-stent restenosis after drug-eluting stent implantation: intravascular ultrasound analysis Intravascular ultrasound assessment of the effects of rotational atherectomy in calcified coronary artery lesions Mechanical complications of everolimus-eluting stents associated with adverse events: an intravascular ultrasound study A volumetric intravascular ultrasound comparison of early drug-eluting stent thrombosis versus restenosis

Original Research2018 Oct 1;19(10):1117-1125.

JOURNAL:Eur Heart J Cardiovasc Imaging. Article Link

Serial changes in the side-branch ostial area after main-vessel stenting with kissing balloon inflation for coronary bifurcation lesions, assessed by 3D optical coherence tomography

Fujimura T, Okamura T, Tateishi H et al. Keywords: 3D optical coherence tomography; KBI; side-branch ostium

ABSTRACT

AIMS - We evaluated the influence of the jailing configuration and guidewire rewiring position in front of the side-branch(SB) ostium before kissing balloon inflation (KBI) against side-branch ostial area (SBOA) at follow-up using 3D optical coherence tomography (3D-OCT).


METHODS AND RESULTS - We retrospectively analysed the cases of the 37 consecutive patients who underwent main-vessel (MV) stenting with KBI for coronary bifurcation lesion under OCT guidance and the follow-up OCT 6-12 months. We divided the patients into two groups, considering both the jailing configuration and the rewiring position by 3D-OCT. We defined the cases that achieved both the distal rewiring and link-free carina configuration as the FCD group, and the other cases were defined as the Non-FCD group. We compared the differences in the SBOA derived by the cut-plane analysis and the number of compartments between the two groups. The median and interquartile range of serial change and percent serial change in SBOA in the FCD group were significantly larger than those in the Non-FCD group [0.43 mm2 (-0.29 to 0.91) vs. -0.65 mm2 (-1.33 to 0.34); P = 0.0136 and 9.47% (-8.37 to 27.33) vs. -13.77% (-31.64 to 10.88); P = 0.0182].


CONCLUSION - This serial OCT study demonstrated that the achievement of both the distal rewiring and link-free carina configuration may be important for the preservation of the SBOA after MV stenting with KBI for coronary bifurcation lesions.