Intravascular ultrasound predictors of side branch occlusion in bifurcation lesions after percutaneous coronary intervention.
BACKGROUND
Percutaneous coronary intervention (PCI) of bifurcation lesion has been associated with a low success rate and a high incidence of procedural complications, including side branch occlusion and myocardial infarction. It remains controversial whether preintervention intravascular ultrasound (IVUS) findings can help to identify side branches likely to occlude after PCI of bifurcation lesions.


RESULTS
From our IVUS database we identified 81 bifurcation lesions in 72 patients. Side branches were classified into 2 groups: group 1 had ostial side branch stenosis due to atherosclerotic plaque only in the main vessel (n=61), and group 2 had plaque truly involved in the side branch ostium (n=20). There was no significant difference between the 2 groups in the extent of ostial stenosis as assessed by angiography. After PCI, 7 side branches occluded in group 2, compared with 5 side branches occluded in group 1 (35% vs 8%, p=0.003).


CONCLUSIONS
Ostial plaque distribution as assessed by IVUS may be one of the consistent predictors of side branch occlusion after PCI.
Furukawa
Eri
E
Cardiovascular Division, Yokohama City University Medical Center, Yokohama, Japan.
Hibi
Kiyoshi
K
Kosuge
Masami
M
Nakatogawa
Tomoyori
T
Toda
Noritaka
N
Takamura
Takeshi
T
Tsukahara
Kengo
K
Okuda
Jun
J
Ootsuka
Fumiyuki
F
Tahara
Yoshio
Y
Sugano
Teruyasu
T
Endo
Tsutomu
T
Kimura
Kazuo
K
Umemura
Satoshi
S
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging*; D001158:Arteries / Q000000981:diagnostic imaging; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging*; D017023:Coronary Angiography; D016208:Databases, Factual; D003936:Diagnosis, Computer-Assisted; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012984:Software; D018084:Ultrasonography, Interventional / Q000379:methods*