Intravascular Ultrasound Guidance Is Associated with a Favorable One-Year Target Vessel Failure Rate and No Residual Myocardial Ischemia after the Percutaneous Treatment of Very Long Coronary Artery Lesions

被引:2
作者
Budrys, Povilas [1 ,2 ]
Baranauskas, Arvydas [1 ,2 ]
Davidavicius, Giedrius [1 ,2 ]
机构
[1] Vilnius Univ, Fac Med, Clin Cardiac & Vasc Dis, LT-03101 Vilnius, Lithuania
[2] Vilnius Univ, Cardiol & Angiol Ctr, Hosp Santaros Klinikos, LT-08410 Vilnius, Lithuania
关键词
percutaneous coronary intervention; intravascular ultrasound; IVUS; fractional flow reserve; FFR; long coronary artery lesions; FRACTIONAL FLOW RESERVE; DRUG-ELUTING STENT; CLINICAL-OUTCOMES; IMPLANTATION; ANGIOGRAPHY; INTERVENTION; PREDICTION; EVENTS;
D O I
10.3390/jcdd9120445
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Studies have shown that percutaneous coronary intervention (PCI) in long coronary artery lesions (>= 30 mm) is associated with more frequent target vessel failure (TVF), and a significant proportion of patients have lesions that continue to induce ischemia after PCI (FFR <= 0.8). We investigated the impact of intravascular ultrasound (IVUS) on the functional PCI result and one-year TVF rate after the percutaneous treatment of long coronary artery lesions. Methods: A total of 80 patients underwent IVUS-guided PCI in long coronary artery lesions. The PCI results were validated with IVUS and FFR. Procedural outcomes were the proportion of patients with: (1) optimal physiology result (post PCI FFR value >= 0.9); (2) optimal anatomy result (all IVUS PCI optimization criteria met); and (3) optimal physiology and anatomy result. The clinical outcome was TVF during a one-year follow-up (target vessel (TV)-related death, TV myocardial infarction, ischemia-driven TV revascularization). Results: The mean stented segment length was 62 mm. The target vessel (TV) was the left anterior descending artery in 82.5% of cases. There were no patients with residual ischemia (FFR <= 0.8) after PCI. Optimal coronary flow (FFR >= 0.9) was achieved in 37.5%; optimal anatomy, as assessed by IVUS, was achieved in 68.4%; and both optimal flow and anatomy were achieved in 25% of patients. Target vessel failure during the 12-month follow-up was 2.5%. Conclusions: In the percutaneous treatment of very long coronary artery lesions, the use of IVUS guidance is associated with a low TVF rate during a one-year follow-up and no residual myocardial ischemia, as assessed by FFR.
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页数:12
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