Predictors of Side Branch Occlusion Immediately after Coronary Stenting: an Intravascular Ultrasound Study.
10.4070/kcj.2002.32.8.655
- Author:
So Yeon CHOI
1
;
Seung Jea TAHK
;
Han Soo KIM
;
Zhe Xun LIAN
;
Myeong Ho YOON
;
Sang Yong YOO
;
Sung Gyun AHN
;
Hyuk Jae CHANG
;
Gyo Seung HWANG
;
Joon Han SHIN
;
Byung Il William CHOI
Author Information
1. Department of Cardiology, Ajou University School of Medicine, Suwon, Korea.
- Publication Type:Original Article
- Keywords:
Ultrasonography, interventional;
Coronary stenosis;
Stents
- MeSH:
Arteries;
Constriction, Pathologic;
Coronary Stenosis;
Humans;
Male;
Multivariate Analysis;
Stents*;
Ultrasonography*;
Ultrasonography, Interventional
- From:Korean Circulation Journal
2002;32(8):655-665
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND AND OBJECTIVES: Previous studies have indicated that side branch occlusion (SBO) remains a significant problem in coronary bifurcation lesions during percutaneous intervention. SUBJECTS AND METHODS: To evaluate the predictors of SBO by intravascular ultrasound (IVUS), 35 patients (28 males, mean age 56+/-11 years) were studied at their left anterior descending artery (LAD)-diagonal branch (DB) bifurcation lesions, prior to coronary intervention for the measurement of the following plaque characteristics: total plaque area (PA), PA of the branch-side semicircle, % area stenosis (%AS) of the LAD, the presence of bull's eye in the DB, the diameter of the vessel and the ostial lumen of the DB, and the LAD-DB angle. SBO was defined as a persistant reduction in the TIMI flow to < OR = 1 by the end of the procedure. RESULTS: The PA of the branch-side semicircle, the vessel diameter and the ostial lumen diameter of the DB all significantly affected the SBO. The total PA and the %AS of the LAD were not related to the SBO. Multivariate analysis identified that the PA of the branch-side semicircle was the only predictor of SBO (odds ratio 3.2, 95% confidence interval 1.3 to 8.6, p=0.015). CONCLUSION: It appears that the plaque distribution of LAD is a major determinant of SBO. These findings support the theory that the plaque shift ("snow plow effect") may be the mechanism of the SBO following stenting.
