Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2012
Prediction of distal embolization during percutaneous coronary intervention for unstable plaques with grayscale and integrated backscatter intravascular ultrasound.
Сравнительное исследованиеСтатьяНазвание и аннотация: Перевод пока не подготовлен
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Shibuya Masahiko, Okamura Atsunori, Hao Hiroyuki, Date Motoo, Higuchi Yoshiharu, Nagai Hiroyuki, Ozawa Makito, Masuyama Tohru, Iwakura Katsuomi, Fujii Kenshi
Аннотация
OBJECTIVES: We performed microscopic examination of the debris collected by a distal protection device and investigated the usefulness of grayscale and integrated backscatter intravascular ultrasound (IB-IVUS) for the prediction of distal embolization during percutaneous coronary intervention (PCI) in cases of unstable angina.
BACKGROUND: The prediction of distal embolization during PCI has not been studied in depth because assessment of distal embolization is difficult.
METHODS: We prospectively studied 39 consecutive patients with unstable angina who underwent PCI with a filter distal protection device. The preprocedural plaque volume at target lesions was measured with grayscale IVUS and plaque characteristics were assessed with IB-IVUS. We performed microscopic examination of the particles collected by the distal protection device.
RESULTS: There was a significant correlation between the plaque volume and the number of the collected particles >100 μm in diameter (r = 0.48, P = 0.0034). Filter no-reflow (FNR) phenomenon was found in nine patients. The plaque volume was significantly greater (355 ± 133 mm(3) vs. 199 ± 90 mm(3) , P = 0.0004), and the lipid ratio was significantly higher (29.3 ± 4.3% vs. 26.1 ± 4.3 P = 0.045) in the FNR group compared with the non-FNR group. Multivariate logistic regression analysis showed that the plaque volume was an independent predictor of FNR phenomenon.
CONCLUSIONS: Although tissue characterization of IB-IVUS may provide additional information for distal embolization, plaque volume is the only significant predictor of distal embolization during PCI.
BACKGROUND: The prediction of distal embolization during PCI has not been studied in depth because assessment of distal embolization is difficult.
METHODS: We prospectively studied 39 consecutive patients with unstable angina who underwent PCI with a filter distal protection device. The preprocedural plaque volume at target lesions was measured with grayscale IVUS and plaque characteristics were assessed with IB-IVUS. We performed microscopic examination of the particles collected by the distal protection device.
RESULTS: There was a significant correlation between the plaque volume and the number of the collected particles >100 μm in diameter (r = 0.48, P = 0.0034). Filter no-reflow (FNR) phenomenon was found in nine patients. The plaque volume was significantly greater (355 ± 133 mm(3) vs. 199 ± 90 mm(3) , P = 0.0004), and the lipid ratio was significantly higher (29.3 ± 4.3% vs. 26.1 ± 4.3 P = 0.045) in the FNR group compared with the non-FNR group. Multivariate logistic regression analysis showed that the plaque volume was an independent predictor of FNR phenomenon.
CONCLUSIONS: Although tissue characterization of IB-IVUS may provide additional information for distal embolization, plaque volume is the only significant predictor of distal embolization during PCI.