Calcification analysis by intravascular ultrasound to define a predictor of left circumflex narrowing after cross-over stenting for unprotected left main bifurcation lesions

Kastsumasa Sato, Toru Naganuma, Charis Costopoulos, Hideo Takebayashi, Kenji Goto, Tadashi Miyazaki, Hiroki Yamane, Arata Hagikura, Yuetsu Kikuta, Masahito Taniguchi, Shigeki Hiramatsu, Azeem Latib, Hiroshi Itoh, Seiichi Haruta, Antonio Colombo

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Objectives: The aim of this study was to identify predictors of significant LCx-ostium compromise after distal unprotected left main coronary artery (ULMCA) stenting on the basis of baseline intravascular ultrasound (IVUS). Background: Provisional single-stenting is considered as the default strategy for non-true bifurcation lesions in ULMCA. However, in certain cases, left circumflex artery (LCx)-ostium stenting is necessary. Methods: A total of 77 patients underwent percutaneous coronary intervention with drug-eluting stents for non-true bifurcation lesions in ULMCA and had IVUS evaluation. Pre-procedural IVUS was performed to measure cross-sectional areas at the following segments: left main trunk, left anterior descending artery (LAD)-ostium. Post-stenting-narrowing at the circumflex ostium (PSN-LCx) was defined as the presence of more than 50% diameter stenosis at the LCx-ostium as determined by quantitative coronary angiography analysis. Results: PSN-LCx occurred in 27 (35%) patients. The presence of calcified plaque at the culprit lesion as identified by IVUS was more frequently observed in the PSN-LCx group as compared to the non-PSN-LCx group (81.5% vs. 22.0%, p. . 60° was an independent predictor of PSN-LCx (odds ratio: 5.12, 95% confidence interval: 1.21-25.01, p. = 0.03). Conclusions: The presence of calcified plaque at the culprit lesion appears to be one of the factors involved in LCx-ostial compromise in non-true bifurcation ULMCA lesions, especially when the calcium arc is >. 60°.

Original languageEnglish
Pages (from-to)80-85
Number of pages6
JournalCardiovascular Revascularization Medicine
Volume15
Issue number2
DOIs
Publication statusPublished - 2014

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Arteries
Coronary Vessels
Drug-Eluting Stents
Percutaneous Coronary Intervention
Coronary Angiography
Pathologic Constriction
Odds Ratio
Confidence Intervals
Calcium

Keywords

  • Bifurcation
  • Intravascular ultrasound
  • Left main coronary artery stenosis
  • Plaque morphology

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Calcification analysis by intravascular ultrasound to define a predictor of left circumflex narrowing after cross-over stenting for unprotected left main bifurcation lesions. / Sato, Kastsumasa; Naganuma, Toru; Costopoulos, Charis; Takebayashi, Hideo; Goto, Kenji; Miyazaki, Tadashi; Yamane, Hiroki; Hagikura, Arata; Kikuta, Yuetsu; Taniguchi, Masahito; Hiramatsu, Shigeki; Latib, Azeem; Itoh, Hiroshi; Haruta, Seiichi; Colombo, Antonio.

In: Cardiovascular Revascularization Medicine, Vol. 15, No. 2, 2014, p. 80-85.

Research output: Contribution to journalArticle

Sato, K, Naganuma, T, Costopoulos, C, Takebayashi, H, Goto, K, Miyazaki, T, Yamane, H, Hagikura, A, Kikuta, Y, Taniguchi, M, Hiramatsu, S, Latib, A, Itoh, H, Haruta, S & Colombo, A 2014, 'Calcification analysis by intravascular ultrasound to define a predictor of left circumflex narrowing after cross-over stenting for unprotected left main bifurcation lesions', Cardiovascular Revascularization Medicine, vol. 15, no. 2, pp. 80-85. https://doi.org/10.1016/j.carrev.2014.01.014
Sato, Kastsumasa ; Naganuma, Toru ; Costopoulos, Charis ; Takebayashi, Hideo ; Goto, Kenji ; Miyazaki, Tadashi ; Yamane, Hiroki ; Hagikura, Arata ; Kikuta, Yuetsu ; Taniguchi, Masahito ; Hiramatsu, Shigeki ; Latib, Azeem ; Itoh, Hiroshi ; Haruta, Seiichi ; Colombo, Antonio. / Calcification analysis by intravascular ultrasound to define a predictor of left circumflex narrowing after cross-over stenting for unprotected left main bifurcation lesions. In: Cardiovascular Revascularization Medicine. 2014 ; Vol. 15, No. 2. pp. 80-85.
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title = "Calcification analysis by intravascular ultrasound to define a predictor of left circumflex narrowing after cross-over stenting for unprotected left main bifurcation lesions",
abstract = "Objectives: The aim of this study was to identify predictors of significant LCx-ostium compromise after distal unprotected left main coronary artery (ULMCA) stenting on the basis of baseline intravascular ultrasound (IVUS). Background: Provisional single-stenting is considered as the default strategy for non-true bifurcation lesions in ULMCA. However, in certain cases, left circumflex artery (LCx)-ostium stenting is necessary. Methods: A total of 77 patients underwent percutaneous coronary intervention with drug-eluting stents for non-true bifurcation lesions in ULMCA and had IVUS evaluation. Pre-procedural IVUS was performed to measure cross-sectional areas at the following segments: left main trunk, left anterior descending artery (LAD)-ostium. Post-stenting-narrowing at the circumflex ostium (PSN-LCx) was defined as the presence of more than 50{\%} diameter stenosis at the LCx-ostium as determined by quantitative coronary angiography analysis. Results: PSN-LCx occurred in 27 (35{\%}) patients. The presence of calcified plaque at the culprit lesion as identified by IVUS was more frequently observed in the PSN-LCx group as compared to the non-PSN-LCx group (81.5{\%} vs. 22.0{\%}, p. . 60° was an independent predictor of PSN-LCx (odds ratio: 5.12, 95{\%} confidence interval: 1.21-25.01, p. = 0.03). Conclusions: The presence of calcified plaque at the culprit lesion appears to be one of the factors involved in LCx-ostial compromise in non-true bifurcation ULMCA lesions, especially when the calcium arc is >. 60°.",
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AU - Sato, Kastsumasa

AU - Naganuma, Toru

AU - Costopoulos, Charis

AU - Takebayashi, Hideo

AU - Goto, Kenji

AU - Miyazaki, Tadashi

AU - Yamane, Hiroki

AU - Hagikura, Arata

AU - Kikuta, Yuetsu

AU - Taniguchi, Masahito

AU - Hiramatsu, Shigeki

AU - Latib, Azeem

AU - Itoh, Hiroshi

AU - Haruta, Seiichi

AU - Colombo, Antonio

PY - 2014

Y1 - 2014

N2 - Objectives: The aim of this study was to identify predictors of significant LCx-ostium compromise after distal unprotected left main coronary artery (ULMCA) stenting on the basis of baseline intravascular ultrasound (IVUS). Background: Provisional single-stenting is considered as the default strategy for non-true bifurcation lesions in ULMCA. However, in certain cases, left circumflex artery (LCx)-ostium stenting is necessary. Methods: A total of 77 patients underwent percutaneous coronary intervention with drug-eluting stents for non-true bifurcation lesions in ULMCA and had IVUS evaluation. Pre-procedural IVUS was performed to measure cross-sectional areas at the following segments: left main trunk, left anterior descending artery (LAD)-ostium. Post-stenting-narrowing at the circumflex ostium (PSN-LCx) was defined as the presence of more than 50% diameter stenosis at the LCx-ostium as determined by quantitative coronary angiography analysis. Results: PSN-LCx occurred in 27 (35%) patients. The presence of calcified plaque at the culprit lesion as identified by IVUS was more frequently observed in the PSN-LCx group as compared to the non-PSN-LCx group (81.5% vs. 22.0%, p. . 60° was an independent predictor of PSN-LCx (odds ratio: 5.12, 95% confidence interval: 1.21-25.01, p. = 0.03). Conclusions: The presence of calcified plaque at the culprit lesion appears to be one of the factors involved in LCx-ostial compromise in non-true bifurcation ULMCA lesions, especially when the calcium arc is >. 60°.

AB - Objectives: The aim of this study was to identify predictors of significant LCx-ostium compromise after distal unprotected left main coronary artery (ULMCA) stenting on the basis of baseline intravascular ultrasound (IVUS). Background: Provisional single-stenting is considered as the default strategy for non-true bifurcation lesions in ULMCA. However, in certain cases, left circumflex artery (LCx)-ostium stenting is necessary. Methods: A total of 77 patients underwent percutaneous coronary intervention with drug-eluting stents for non-true bifurcation lesions in ULMCA and had IVUS evaluation. Pre-procedural IVUS was performed to measure cross-sectional areas at the following segments: left main trunk, left anterior descending artery (LAD)-ostium. Post-stenting-narrowing at the circumflex ostium (PSN-LCx) was defined as the presence of more than 50% diameter stenosis at the LCx-ostium as determined by quantitative coronary angiography analysis. Results: PSN-LCx occurred in 27 (35%) patients. The presence of calcified plaque at the culprit lesion as identified by IVUS was more frequently observed in the PSN-LCx group as compared to the non-PSN-LCx group (81.5% vs. 22.0%, p. . 60° was an independent predictor of PSN-LCx (odds ratio: 5.12, 95% confidence interval: 1.21-25.01, p. = 0.03). Conclusions: The presence of calcified plaque at the culprit lesion appears to be one of the factors involved in LCx-ostial compromise in non-true bifurcation ULMCA lesions, especially when the calcium arc is >. 60°.

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KW - Intravascular ultrasound

KW - Left main coronary artery stenosis

KW - Plaque morphology

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