Factors associated with aorto-ostial stent coverage during intravascular ultrasound-guided percutaneous coronary intervention to severely narrowed non-ostial right coronary artery lesions

Abstract

Introduction: In percutaneous coronary intervention (PCI) to atherosclerotic lesions in the right coronary artery (RCA), coronary artery dissection in the ostium of the RCA is a rare but fatal complication. Stent implantation to the ostium of RCA may be selected for the prevention of aorto-ostial dissection.Aim: To find factors associated with aorto-ostial stent coverage to mild to moderate ostial stenosis during the treatment of severely narrowed non-ostial RCA lesions.Material and methods: The primary interest was to find factors associated with ostial stent coverage using multivariate regression analysis. We included 236 patients who underwent intravascular ultrasound (IVUS)-guided PCI to severely narrowed RCA lesions with mild to moderate ostial stenosis, and divided those into the ostial-coverage group (n = 52) and the non-coverage group (n = 184).Results: The prevalence of continuous ostial plaque detected by intravascular ultrasound (IVUS) was significantly greater in the ostial-coverage group (84.6%) than in the non-coverage group (52.9%) (p < 0.001). Multivariate logistic regression analysis revealed that continuous ostial plaque detected by IVUS (OR = 5.398, 95% CI: 2.322-12.553, p < 0.001) was significantly associated with ostial stent coverage after controlling confounding factors. Ischaemia-driven target vessel revascularization was less frequently observed in the ostial-coverage group than in the non-coverage group, without reaching statistical significance (p = 0.069).Conclusions: Continuous ostial plaque detected by IVUS was significantly associated with ostial stent coverage to the mild to moderate stenosis when PCI to non-ostial, severely narrowed RCA lesions was performed. The use of IVUS may enhance the safety but may increase the total stent length in PCI to RCA.

Comparison of door-to-balloon time and in-hospital outcomes in patients with ST-elevation myocardial infarction between before versus after COVID-19 pandemic

“…Diagnostic ST elevation was defined as new ST elevation at the J point in at least two contiguous leads of 2 mm (0.2 mV), and the AMI patients with ST elevation were diagnosed as STEMI [ 16 ]. The definitions of hypertension, diabetes mellitus, and dyslipidemia are described elsewhere [ 17 , 18 ]. We used the laboratory data at admission.…”

Impact of Excessive Increase in Systolic Blood Pressure after Exercise on Clinical Outcomes in Patients with ST-Segment Elevation Myocardial Infarction

“…Diagnostic ST elevation was defined as new ST elevation at the J point in at least two contiguous leads of 2 mm (0.2 mV), and the AMI patients with ST elevation were diagnosed as STEMI [11,12]. The definitions of hypertension, diabetes mellitus, and dyslipidemia were described elsewhere [13,14]. We used the laboratory data recorded at admission.…”