Intervenção percutânea em lesão de tronco de coronária esquerda não protegido

Quizhpe, Arturo; Ortega, Carlos; Córdova, María Augusta; Vintimilla, Juan; Vázquez, Xavier; Garcés, Juan-José; González, María Fernanda; Astudillo, Adriana; Salto, Ender; Córdova, Diego

doi:10.1590/s2179-83972013000400009

Cited by 2 publications

(4 citation statements)

References 5 publications

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“…By determining characteristics of the lesions and the dimensions of the artery with high accuracy, IVUS contributes to the adequate selection of the stent and technique to be used, in addition to evaluating the need for additional balloon expansion, or the use of rotational atherectomy in lesions with severe calcification. 7,13,14 Results of the study by Fujii et al demonstrated that inappropriate expansion and residual segmental stenosis were independent risk factors for post-procedure restenosis and stent thrombosis. 15,16 In this study, the thrombosis rate was 2.9%, and two thromboses occurred during an intervention performed with IVUS, and one thrombosis occurred 5 days after a stent implantation in the left circumflex artery, a procedure performed without IVUS.…”

Section: Discussionmentioning

confidence: 99%

“…FFR has been indicated for borderline lesions (40% to 50%) and concerns about side branch entrapment. 7 Throughout this series, no FFR was available in this service, and such an assessment was not possible. As to rotational atherectomy, the Rotablator™ was used in 9.7% of procedures, a value above the general average when compared to the treatment of any other vessel, which reaches 2.5%, as reported by Seca et al, indicating greater complexity and calcifications of LMCA lesions.…”

Section: Discussionmentioning

confidence: 99%

“…Angiographic success was defined as a successful stent implantation, with <20% residual stenosis and final Thrombolysis in Myocardial Infarction (TIMI) 3 flow, whereas intervention success was defined as angiographic success with no MACCE during the period of hospitalization. 7,8 In addition, in the post-PCI telephone follow-up, patients were asked about the absence or presence of symptoms (chest pain or shortness of breath), physical exercise, a return visit to a cardiologist, and the need for further intervention (PCI or cardiac surgery).…”

Section: Methodsmentioning

confidence: 99%

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Analysis of percutaneous coronary intervention outcomes in unprotected left main coronary artery lesions

Guimarães¹,

Gardenghi²,

Santana³

et al. 2022

J Transcat Intervent

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Background: Significant lesions in the left main coronary artery are found in approximately 5% of patients undergoing coronary angiography, with most cases involving multiple vessels and affecting the distal bifurcation. A coronary artery bypass graft surgery is considered the preferred treatment for unprotected left main coronary artery lesions. However, with the advancement of techniques and the introduction of new drug-eluting stents, percutaneous coronary intervention has been considered a viable strategy, with favorable results. The objective of this study was to analyze the outcomes in patients with unprotected left main coronary artery lesions undergoing percutaneous coronary intervention. Methods: Electronic data from patients undergoing percutaneous coronary intervention between December 2017 and January 2020 at a single center were analyzed to assess clinical and angiographic characteristics and clinical outcomes. Results: A total of 103 patients with significant unprotected left main coronary artery lesions were included; in that, 66% were male, 88.3% were hypertensive, and 87.4% had normal ventricular function. Lesions involving the bifurcation were identified in 73.8% of patients, 36.9% had concomitant lesions in the three major epicardial vessels, and 42.7% had an intermediate SYNTAX score (23 to 32 points). Angiographic success was achieved in 100% of cases, with four (3.9%) adverse cardiac and cerebrovascular events, with 2.9% mortality. Conclusion: Hospital results support percutaneous coronary intervention as a safe procedure, with excellent angiographic results and low rates of adverse cardiac and cerebrovascular events. We concluded that PCI is an option to coronary artery bypass graft surgery and is a very viable option for surgical treatment of unprotected left main coronary artery lesions.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Analysis of percutaneous coronary intervention outcomes in unprotected left main coronary artery lesions

Guimarães¹,

Gardenghi²,

Santana³

et al. 2022

J Transcat Intervent

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“…26 Outros autores latino-americanos descrevem bons resultados em relatos de casos ou estudos com amostras pequenas de pacientes com escore SYNTAX de baixo ou médio risco. [27][28][29] Costantini et al 30 descrevem experiência com 142 pacientes, incluindo 63 casos com SYNTAX de alto risco e com uso de ultrassom intravascular em grande parte dos casos. Os autores apresentaram 81,0% de sucesso avaliado por ultrassom e taxa de mortalidade hospitalar de 1,4%, resultados semelhantes aos encontrados na amostra do presente estudo.…”

Section: Discussionunclassified

Intervenção Coronariana Percutânea em Lesões não Protegidas de Tronco

Grion¹,

Grion²,

Silverio³

et al. 2021

Arquivos Brasileiros De Cardiologia

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Fundamento: O advento dos stents farmacológicos permitiu que a intervenção coronariana percutânea apresentasse resultados seguros nas lesões de tronco da artéria coronária esquerda.Objetivos: Analisar os resultados do tratamento percutâneo da lesão não protegida de tronco da artéria coronária com a utilização de ultrassom intravascular. Métodos: Estudo de série de casos consecutivos realizado no período de janeiro de 2010 a dezembro de 2018. Coletaram-se dados clínicos dos pacientes, assim como escores prognósticos e dados da lesão coronariana. Considerouse de sucesso a lesão residual menor que 50% à angiografia e a área mínima da luz maior que 6 mm² ao ultrassom intravascular. O nível de significância adotado foi de 5%.Resultados: Analisaram-se 107 casos. A lesão multiarterial foi predominante, sendo com maior frequência (39,25%) encontradas lesões em três vasos além do tronco coronariano. O escore SYNTAX apresentou média de 46,80 (DP: 22,95), e 70 (65,42%) pacientes tiveram escore SYNTAX acima de 32 pontos. Considerou-se sucesso angiográfico da intervenção percutânea em 106 (99,06%) pacientes. A taxa geral de evento maior cardíaco e cerebrovascular no desfecho hospitalar foi 6,54%, sendo semelhante nos pacientes com escore SYNTAX ≤ 32 (8,10%) e ≥ 33 (5,71%; p = 0,68) .Conclusões: A intervenção percutânea em casos de lesão não protegida de tronco coronariano foi realizada com segurança e apresentou ótimos resultados. Atingiu-se alto sucesso angiográfico de tratamento guiado pelo ultrassom intravascular. A taxa de eventos cardíacos e cerebrovasculares maiores foi semelhante entre os pacientes de menor e de maior risco.

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Intervenção percutânea em lesão de tronco de coronária esquerda não protegido

Cited by 2 publications

References 5 publications

Analysis of percutaneous coronary intervention outcomes in unprotected left main coronary artery lesions

Analysis of percutaneous coronary intervention outcomes in unprotected left main coronary artery lesions

Intervenção Coronariana Percutânea em Lesões não Protegidas de Tronco

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