Procedural outcomes with use of the flash ostial system in aorto-coronary ostial lesions.
BACKGROUND
The Flash Ostial system (Ostial Corporation, Sunnyvale, CA) was designed to optimize implantation of aorto-ostial coronary stents by flaring the proximal stent struts against the aortic wall.


METHODS
We retrospectively reviewed the medical record, angiograms, and intravascular ultrasound images of 22 aorto-ostial percutaneous coronary interventions performed at our institution between March and September 2015. The Flash Ostial system was used in 13 cases (59%).


RESULTS
Mean age was 67 ± 8 years and all patients were men. The target vessel was the right coronary artery (59%), left main (27%), or a saphenous vein graft (14%); 59% of the lesions had moderate/severe calcification. The mean number of predilation balloons was 1.8 ± 1.6, mean Flash ostial balloon diameter was 3.3 ± 0.5 mm and mean inflation pressure was 13.1 ± 4.0 atmospheres. Intravascular ultrasonography (available for 19 patients) revealed mean ostial minimum lumen cross-sectional area (MLA) of 9.2 ± 3.0 mm2and reference MLA of 8.5 ± 2.7 mm2. The percent difference between ostial and reference MLA was higher in cases in which the Flash Ostial system was used versus those where it was not (9.6 ± 5.5% vs. 4.0 ± 2.8%, P = 0.03). All stent struts were well apposed. Technical success was 100%. One patient developed a left groin pseudoaneurysm treated with thrombin injection and one patient had a periprocedural myocardial infarction. Median contrast, fluoroscopy time, and procedure time were 235 mL, 33 min, and 118 min, respectively.


CONCLUSIONS
The Flash Ostial system can be successfully used in aorto-ostial stenting, resulting in large ostial vessel MLA. © 2016 Wiley Periodicals, Inc.
VA North Texas Health Care System and University of Texas Southwestern Medical Center, Dallas, Texas.
Phuong-Khanh J
PJ
Nguyen-Trong
VA North Texas Health Care System and University of Texas Southwestern Medical Center, Dallas, Texas.
Jose Roberto
JR
Martinez Parachini
VA North Texas Health Care System and University of Texas Southwestern Medical Center, Dallas, Texas.
Erica
E
Resendes
VA North Texas Health Care System and University of Texas Southwestern Medical Center, Dallas, Texas.
Aris
A
Karatasakis
VA North Texas Health Care System and University of Texas Southwestern Medical Center, Dallas, Texas.
Barbara A
BA
Danek
VA North Texas Health Care System and University of Texas Southwestern Medical Center, Dallas, Texas.
Aya
A
Alame
VA North Texas Health Care System and University of Texas Southwestern Medical Center, Dallas, Texas.
Lorenza B
LB
Makke
VA North Texas Health Care System and University of Texas Southwestern Medical Center, Dallas, Texas.
Colby R
CR
Ayers
VA North Texas Health Care System and University of Texas Southwestern Medical Center, Dallas, Texas.
Michele
M
Roesle
VA North Texas Health Care System and University of Texas Southwestern Medical Center, Dallas, Texas.
Bavana
B
Rangan
VA North Texas Health Care System and University of Texas Southwestern Medical Center, Dallas, Texas.
Subhash
S
Banerjee
VA North Texas Health Care System and University of Texas Southwestern Medical Center, Dallas, Texas.
Emmanouil S
ES
Brilakis
D000368:Aged; D017541:Aneurysm, False / Q000188:drug therapy / Q000209:etiology; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation*; D062906:Cardiac Catheters; D003287:Contrast Media / Q000008:administration & dosage; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000009:adverse effects; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000628:therapy*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000628:therapy*; D004867:Equipment Design; D005471:Fluoroscopy; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D015641:Radiography, Interventional / Q000379:methods; D012189:Retrospective Studies; D012501:Saphenous Vein / Q000000981:diagnostic imaging / Q000637:transplantation; D015607:Stents; D013781:Texas; D013917:Thrombin / Q000008:administration & dosage; D013997:Time Factors; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
D003287:Contrast Media; D013917:Thrombin
coronary artery disease; intravascular ultrasound; percutaneous coronary intervention