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Comprehensive intravascular ultrasound assessment of stent area and its impact on restenosis and adverse cardiac events in 403 patients with unprotected left main disease Comparison of inhospital mortality, length of hospitalization, costs, and vascular complications of percutaneous coronary interventions guided by ultrasound versus angiography Histopathologic validation of the intravascular ultrasound diagnosis of calcified coronary artery nodules 3-Year Outcomes of the ULTIMATE Trial Comparing Intravascular Ultrasound Versus Angiography-Guided Drug-Eluting Stent Implantation Combined use of OCT and IVUS in spontaneous coronary artery dissection Use of IVUS guided coronary stenting with drug eluting stent: a systematic review and meta-analysis of randomized controlled clinical trials and high quality observational studies Comparison of plaque characteristics in narrowings with ST-elevation myocardial infarction (STEMI), non-STEMI/unstable angina pectoris and stable coronary artery disease (from the ADAPT-DES IVUS Substudy) Usefulness of intravascular ultrasound to predict outcomes in short-length lesions treated with drug-eluting stents Long-term outcomes with use of intravascular ultrasound for the treatment of coronary bifurcation lesions Intracoronary stenting without anticoagulation accomplished with intravascular ultrasound guidance
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Clinical Case Study2018 Sep 23. [Epub ahead of print]

JOURNAL：Catheter Cardiovasc Interv. Article Link

Open sesame technique in percutaneous coronary intervention for ST-elevation myocardial infarction

Kimura T, Nishibori Y, Miki K et al. Keywords: acute coronary syndrome; bifurcation lesion; percutaneous coronary intervention

ABSTRACT

In patients with ST-elevation myocardial infarction (STEMI), delays in reperfusion attenuate the benefit of primary percutaneous coronary intervention (PCI) and associate with higher mortality rates. Although PCI operators are making their best effort in time saving for reperfusion, it is sometimes challenging and takes time to pass the guide wire across the target lesions. A totally occluded lesion in which a side branch was bifurcating at the proximal end of the occluded segment is one of the most technically challenging anatomies of the target lesion because it is difficult to identify the entry point of the occluded segment. A side branch technique, termed "Open Sesame Technique" (OST), has been previously introduced for chronic total occlusion (CTO) lesion in which a side branch was bifurcating at the proximal end of the occluded segment. We herein present two cases applying this technique in STEMI with totally occluded lesions at bifurcation as a culprit lesion, in which the entry point was not identified on the initial angiography. PCI were performed successfully using the OST in both cases, which resulted in saving procedural time and contrast volume without any complications. This technique can be effective not only in PCI for CTO lesions but also in primary PCI for STEMI cases with occluded bifurcation lesions.

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