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血流储备分数

Abstract

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Diagnosis of ischemia-causing coronary stenoses by noninvasive fractional flow reserve computed from coronary computed tomographic angiograms. Results from the prospective multicenter DISCOVER-FLOW Fractional Flow Reserve-Guided Complete Revascularization Improves the Prognosis in Patients With ST-Segment-Elevation Myocardial Infarction and Severe Nonculprit Disease: A DANAMI 3-PRIMULTI Substudy (Primary PCI in Patients With ST-Elevation Myocardial Infarction and Multivessel Disease: Treatment Prognostic Implication of Thermodilution Coronary Flow Reserve in Patients Undergoing Fractional Flow Reserve Measurement Physiologic Characteristics and Clinical Outcomes of Patients With Discordance Between FFR and iFR Relationship between fractional flow reserve value and the amount of subtended myocardium Impact of myocardial supply area on the transstenotic hemodynamics as determined by fractional flow reserve High-Resolution Cardiac Magnetic Resonance Imaging Techniques for the Identification of Coronary Microvascular Dysfunction Diagnostic Performance of Angiogram-Derived Fractional Flow Reserve: A Pooled Analysis of 5 Prospective Cohort Studies

Original Research2017 Dec 5. [Epub ahead of print]

JOURNAL:Catheter Cardiovasc Interv. Article Link

Rotational atherectomy and new-generation drug-eluting stent implantation

Hachinohe D, Kashima Y, Kanno D et al. Keywords: newer-generation drug-eluting stents; percutaneous coronary intervention; rotational atherectomy

ABSTRACT


OBJECTIVES - The aim of this study was to evaluate the clinical outcomes of rotational atherectomy (RA) followed by new-generation drug-eluting stent (DES) implantation in patients with an extensive amount of calcified and fibrotic plaque.


BACKGROUND - RA followed by new-generation DES implantation for complex lesions has not been thoroughly evaluated.


METHODS - A total of 744 consecutive patients (770 lesions) treated with new-generation DES implantation following RA for de novo lesions between January 2013 and November 2015 were retrospectively identified using our institutional database. Clinical outcomes at 12 months were evaluated and the independent predictors of all-cause death and target vessel failure (TVF) were assessed using Cox regression models.


RESULTS - Target lesion revascularization occurred in 22 lesions (2.9%) and TVF occurred in 51 lesions (6.6%). In a multivariate analysis, hemodialysis, non-ST-segment elevation acute coronary syndrome, low ejection fraction, and HbA1c ≧ 7% were associated with 12-month mortality. Hemodialysis and right coronary artery were identified as independent predictors of TVF (hazard ratio (HR) 4.107, 95% confidence interval (CI) 2.194-7.685, P < .001; HR 2.491, 95% CI 1.023-6.062, P = .044, respectively).


CONCLUSIONS - A good debulking with RA followed by new-generation DES implantation is recommended for patients with an excessive amount of calcified and fibrotic plaque, as this will likely improve the clinical outcomes.


© 2017 Wiley Periodicals, Inc.