Validation of the <scp>V‐RESOLVE (V</scp>isual <scp>E</scp>stimation for <scp>R</scp>isk pr<scp>E</scp>diction of <scp>S</scp>ide <scp>B</scp>ranch <scp>O</scp>cc<scp>L</scp>usion in <scp>C</scp>oronary <scp>B</scp>ifurcation inter<scp>VE</scp>ntion) score system

He, Yuan; Zhang, Dong; Yin, Dong; Zhu, Chen-Gang; Feng, Lei; Song, Chenxi; Chen, Changzhe; Xu, Bo; Dou, Kefei

doi:10.1002/ccd.27499

Cited by 11 publications

(9 citation statements)

References 23 publications

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“…The possible reasons for the sensitivity of this study are as follows. First, the patients enrolled in the study by Dou, et al presented with bifurcation lesions with a high risk of SB occlusion, defined as a V-RESOLVE score of !12 points, 28,29) and detecting the advantage of reducing SB occlusion might be easier in the active than conservative SB-P group. Second, a small subset of patients in the authors' experimental group received an elective two-stent strategy (SB RVD of !2.5 mm), which may have decreased the incidence of SB occlusion in the active SB-P group of our study, although it has been well demonstrated that the effect of reducing SB oc-CORONARY SIDE BRANCH PROTECTION STRATEGY clusion in the experimental group is driven mainly by a provisional SB stenting strategy with the JBT technique.…”

Section: Discussionmentioning

confidence: 99%

Active Versus Conventional Side Branch Protection Strategy for Coronary Bifurcation Lesions

et al. 2021

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The side branch (SB) provisional stenting strategy is currently the recommended approach for most coronary bifurcation lesions. However, this strategy may result in SB deterioration, which is associated with an increased incidence of periprocedural myocardial infarction (PMI) and may adversely affect the long-term prognosis. Various techniques for SB protection (SB-P) have been developed to reduce SB occlusion and improve the clinical prognosis. This meta-analysis was performed to compare the outcomes of an active SB-P strategy of jailed balloon technique, balloon-stent kissing technique, and jailed Corsair technique versus the conventional SB-P strategy based on jailed wire technique.This meta-analysis included 5 studies (4 randomized and 1 observational) involving a total of 1,174 patients in whom the active and conventional SB-P strategies were compared. Fixed-and random-effects models were used to calculate summary risk ratios (RRs).The risk of SB occlusion was significantly lower in active SB-P strategy [RR 0.47, 95% confidence interval (CI) 0.30-0.73 in fixed-effect model; RR 0.52, 95% CI 0.31-0.87 in random-effect model]. The risk of PMI was similar between the two strategies (RR 0.63, 95% CI 0.30-1.33 in fixed-effect model; RR 0.71, 95%CI 0.20-2.48 in random-effect model). The rate of long-term major adverse cardiovascular events was similar between the groups (RR 0.48, 95% CI 0.15-1.48 in fixed-effect model; RR 0.49, 95% CI 0.16-1.52 in randomeffect model).The active SB-P strategy in coronary bifurcation lesions is associated with reduced SB deterioration, but it does not decrease PMI or improve the long-term prognosis.

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Section: Discussionmentioning

confidence: 99%

Active Versus Conventional Side Branch Protection Strategy for Coronary Bifurcation Lesions

et al. 2021

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“…It is necessary to expand the sample size in future studies. (3) This study only included the confounding factors of hypertension history, diabetes history, hyperlipidemia history, and smoking history. Other confounding factors that affect the occurrence of plaques were not included, which may have biased the results of this study.…”

Section: Discussionmentioning

confidence: 99%

“…With the development of interventional radiology, the geometric parameters of left coronary artery (LCA) bifurcation zone have attracted a large amount of attention because it is highly related to the complex decision-making regarding treatment and the incidence of perioperative and postoperative adverse clinical events [1][2][3]. Additionally, the geometry of the blood vessels has been proven to be one of the causes of atherosclerosis.…”

Section: Introductionmentioning

confidence: 99%

Coronary computed tomography angiography study on the relationship between the Ramus Intermedius and Atherosclerosis in the bifurcation of the left main coronary artery

Zhang

Dong

et al. 2023

BMC Med Imaging

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Objective This study aimed to explore the relationship between the ramus intermedius (RI) and atherosclerosis in the bifurcation of the left coronary artery (LCA). Methods Screening patients who underwent CCTA from January to September 2021, 100 patients with RI (RI group) and 100 patients without RI (no-RI group) were randomly enrolled, Evaluation of RI distribution characteristics and left main coronary artery(LM),Left anterior descending branch(LAD),left circumflex branch(LCX) proximal segment plaque distribution, measurement of LAD-LCX bifurcation angle(∠LAD-LCX),Comparison of the three distribution characteristics with the incidence of plaques in the left main trunk bifurcation area (LM, LAD, LCX) between groups and within the RI group. Results The difference in the incidence of plaques in the proximal LCX and the LM between the RI group and the no-RI group were not statistically significant (P > 0.05). The incidence of plaques in the proximal LAD in the RI group was significantly higher than that in the non-RI group (77% versus 53%, P < 0.05). However, there was no statistically significant difference between the two groups after PSM. A univariate logistic regression analysis revealed that an RI was a risk factor for plaque formation in the proximal LAD (P < 0.001), and a multivariate logistic regression analysis revealed that an RI was not an independent risk factor for plaque formation in the proximal LAD (P > 0.05). When compared within the RI group, the difference in the incidence of plaques in the proximal segment of LAD, the proximal segment of LCX, and the LM among the different distribution groups of RI was not statistically significant, respectively (P > 0.05). Conclusion RI is not an independent risk factor for atherosclerosis in the left coronary artery bifurcation zone, but it may indirectly increase the risk of atherosclerosis in the proximal segment of the LAD.

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“…The score system encompasses six independent visually assessed risk factors, four from baseline angiography (plaque distribution, diameter stenosis of bifurcation core, bifurcation angle, and MV/SB diameter ratio), and two from prestenting angiography (MV thrombolysis in myocardial infarction [TIMI] flow grade and SB diameter stenosis before MV stenting). It has been further validated that the SB occlusion rate was significantly higher in the high‐risk group stratified by the V‐RESOLVE score, than in the nonhigh‐risk group (26.18% vs. 3.48%) 11 . Unlike other bifurcations that are more distal, the LM bifurcation has several unique specificities, including larger diameter of SB and bifurcation angle, which might affect the predictive performance of the V‐RESOLVE score 9 .…”

Section: Introductionmentioning

confidence: 95%

“…It has been further validated that the SB occlusion rate was significantly higher in the high-risk group stratified by the V-RESOLVE score, than in the nonhigh-risk group (26.18% vs. 3.48%). 11 Unlike other bifurcations that are more distal, the LM bifurcation has several unique specificities, including larger diameter of SB and bifurcation angle, which might affect the predictive performance of the V-RESOLVE score. 9 Therefore, this study aimed to determine the value of the V-RESOLVE score in unprotected LM bifurcation PCI.…”

mentioning

confidence: 99%

Validation of the V‐RESOLVE (Visual Estimation for Risk prEdiction of Side Branch OccLusion in Coronary Bifurcation interVEntion) score system in unprotected left main bifurcation

Zhang

Rui

et al. 2022

Cathet Cardio Intervent

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Objectives This study aimed to assess the risk of side branch (SB) occlusion using the V‐RESOLVE (The Visual Estimation for Risk prEdiction of Side Branch OccLusion in Coronary Bifurcation interVEntion) score in unprotected left main (LM) bifurcation percutaneous coronary intervention (PCI). Background The V‐RESOLVE score is a validated score system, based on visual estimation of angiographic data, for prediction of the risk of SB occlusion after main vessel (MV) stenting in non‐LM bifurcation lesions. However, its predictive value for unprotected LM bifurcation lesions remains to be validated. Methods From January 2014 to December 2016, 855 patients undergoing unprotected LM bifurcation PCI using a provisional strategy were included. Baseline and prestenting angiographic data were analyzed, and the V‐RESOLVE score was calculated. SB occlusion was defined as any decrease in thrombolysis in myocardial infarction (TIMI) flow grade or the absence of flow in the SB after MV stenting. The predictive performance of the V‐RESOLVE score was judged by discrimination, calibration, and clinical application. Results vSB occlusion occurred in 19 (2.2%) of 855 unprotected LM bifurcation PCI procedures using a provisional strategy. The V‐RESOLVE score for SB occlusion had brilliant discrimination (the area under the receiver operating characteristic curve = 0.80, 95% confidence interval [CI]: 0.77–0.84) and good calibration (Hosmer–Lemeshow: p = 0.154). Stratified by the V‐RESOLVE score, significantly higher rates of SB occlusion were observed in the high‐risk group (score: 12–43) compared with the nonhigh‐risk group (score: 0–11) (4.4% vs. 0.6%, p < 0.001). Conclusions The V‐RESOLVE score is a promising tool to predict the risk of SB occlusion and facilitate decision‐making for unprotected LM bifurcation PCI.

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Validation of the V‐RESOLVE (Visual Estimation for Risk prEdiction of Side Branch OccLusion in Coronary Bifurcation interVEntion) score system

Abstract: The V-RESOLVE score system is a useful tool to help risk prediction for SB occlusion and decision-making in bifurcation intervention.

Cited by 11 publications

References 23 publications

Active Versus Conventional Side Branch Protection Strategy for Coronary Bifurcation Lesions

Active Versus Conventional Side Branch Protection Strategy for Coronary Bifurcation Lesions

Coronary computed tomography angiography study on the relationship between the Ramus Intermedius and Atherosclerosis in the bifurcation of the left main coronary artery

Validation of the V‐RESOLVE (Visual Estimation for Risk prEdiction of Side Branch OccLusion in Coronary Bifurcation interVEntion) score system in unprotected left main bifurcation

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