Difference in vascular response between sirolimus-eluting- and everolimus-eluting stents in ostial left circumflex artery after unprotected left main as observed by optical coherence tomography. (1st March 2017)

• Record Type: Journal Article
• Authors: Fujino, Yusuke; Attizzani, Guilherme F.; Tahara, Satoko; Naganuma, Toru; Takagi, Kensuke; Yabushita, Hiroto; Wang, Wei; Tanaka, Kentaro; Matsumoto, Takahiro; Kawamoto, Hiroyoshi; Yamada, Yuya; Amano, Shinnosuke; Watanabe, Yusuke; Warisawa, Takayuki; Sato, Tomohiko; Mitomo, Satoru; Kurita, Naoyuki; Ishiguro, Hisaaki; Hozawa, Koji; Tsukahara, Takahiro; Motosuke, Masahiro; Bezerra, Hiram G.; Nakamura, Shotaro; Nakamura, Sunao
• Is Part Of: International journal of cardiology. Volume 230(2017)
• Page Start: 284
• Page End: 292
• Publication Date: 2017-03-01
• Subjects: AO adjacent to the ostium -- DES drug eluting stents -- EES everolimus-eluting stents -- EF ejection fraction -- KBT kissing-balloon technique -- LAD left anterior descending artery -- LCx left circumflex artery -- NIH neointimal hyperplasia -- OCT optical coherence tomography -- OO opposite to the ostium -- PCI percutaneous coronary intervention -- POC polygon of confluence -- POT proximal optimization technique -- QCA quantitative coronary angiography -- ROI region of interest -- SB side branch -- SES sirolimus-eluting stents -- SO side branch ostium -- SIT strut-level intimal thickness -- TLR target lesion revascularization -- TVF target vessel failure -- ULM unprotected left main coronary artery; Left main coronary artery disease -- Percutaneous coronary intervention -- Kissing balloon technique -- Optical coherence tomography; Cardiology -- Periodicals; Electronic journals; 616.12
• DOI: 10.1016/j.ijcard.2016.12.122
• Languages: English
• ISSNs: 0167-5273

Abstract

Abstract: Background: Kissing-balloon technique (KBT) is commonly performed during percutaneous coronary intervention of distal unprotected left main coronary artery (ULM) aiming at obtaining optimal opening of the side branch (left circumflex artery; LCX) ostium. Nonetheless, detailed evaluation of vascular response to stents in LCX ostium is lacking. We therefore evaluated the vascular response to different drug-eluting stents (DES) in ostial LCX after ULM by means of optical coherence tomography (OCT). Methods: We prospectively enrolled 38 consecutive patients with ULM disease, who were treated with single-stent procedure using DES, crossover the ULM-left anterior descending artery (LAD) followed by KBT. Twelve patients were treated with sirolimus-eluting stents (SES) and 26 patients were treated with everolimus-eluting stents (EES). OCT was conducted at post-PCI and 9-month follow-up. We evaluated the DES–vessel interactions and number of stent struts at the side branch (LCX) ostium (SO) at post-PCI, and compared the narrowing of ostial area at LCX between SES and EES. Results: Post-procedure, the number of stent struts at SO was significantly higher in SES compared to EES (median 14.47% vs 0.19%, p < 0.001). The narrowing of LCX ostial area at follow-up was more pronounced in SES compared with EES (29.16% vs 2.46%, respectively, p < 0.001). Linear regression analysis showed a high correlation between the number of stent struts in LCX ostium and ostial area narrowing ( r = 0.771, p < 0.001). Conclusions: OCT showed differences between EES– and SES–vessel interactions at ULM bifurcation PCI. Number of LCX ostium struts at post-PCI impacted the narrowing of ostial area at 9-month follow-up.