Division of Cardiology, Nanjing First Hospital, Nanjing Medical University, 68 Changle Rd, 210006, Nanjing, China.
Herz. 2021 Mar;46(2):178-187. doi: 10.1007/s00059-019-04856-4. Epub 2019 Sep 25.
Our study analyzed the relationship between the neointimal strut bridge and jailed side-branch (SB) ostial area in patients with coronary heart disease (CHD) who had a single drug-eluting stent (DES) crossover of the left anterior descending coronary artery (LAD)/diagonal branch (D) bifurcation.
A total of 64 CHD patients with an LAD/D bifurcation treated by optical coherence tomography (OCT)-guided single-DES implantation and followed up at 1 year after primary percutaneous intervention (pPCI) were enrolled in our study. According to the two-dimensional OCT results, patients were divided into a non-neointimal bridge group (n = 44) and a neointimal bridge group (n = 20). Basic clinical, angiographic, 2D and 3D OCT, and DES results were analyzed.
The blood lipid levels of the two groups after the 1‑year follow-up were lower than the levels 1 year earlier (p < 0.05). There was a notable decrease in the SB ostial minimum lumen diameter and area directly after pPCI vs. before pPCI in both groups. The diameter stenosis directly after pPCI showed a clear increase compared with the pre-pPCI value in both groups (p < 0.05 or p < 0.01, respectively). The strut distance of the neointimal bridges in the neointimal bridge group was greater than in the non-neointimal bridge group (p < 0.05). A clearly short strut distance of the neointimal bridge was observed compared with the strut distance of the non-neointimal bridge in the neointimal bridge group (p < 0.05). A larger neointimal bridge area and a smaller SB ostial area were found in the neointimal bridge group compared with the non-neointimal bridge group (p < 0.05 or p < 0.01, respectively).
A short strut distance facilitated formation of a neointimal bridge, which significantly influenced the SB ostial area after single crossover stenting of the SB orifice at the 1‑year follow-up.
本研究分析了经光学相干断层扫描（OCT）指导下左前降支（LAD）/对角支（D）分叉病变单枚药物洗脱支架（DES）交叉治疗的冠心病（CHD）患者，支架梁桥与分支开口被桥接的边支（SB）开口区之间的关系。
共纳入 64 例经 OCT 指导行单枚 DES 植入治疗 LAD/D 分叉病变且经皮冠状动脉介入治疗（pPCI）后 1 年行 OCT 随访的 CHD 患者。根据二维 OCT 结果将患者分为非支架梁桥组（n=44）和支架梁桥组（n=20）。分析两组的基本临床、血管造影、二维和三维 OCT 及 DES 结果。
两组患者 1 年后的血脂水平均低于 1 年前（p<0.05）。两组患者 pPCI 后即刻 SB 开口最小管腔直径和面积均较 pPCI 前明显减小。两组患者 pPCI 后即刻的直径狭窄率均较 pPCI 前明显增加（p<0.05 或 p<0.01）。支架梁桥组的支架梁桥桥体支架梁间距大于非支架梁桥组（p<0.05）。支架梁桥组桥体支架梁桥体支架梁间距明显小于非支架梁桥桥体支架梁间距（p<0.05）。支架梁桥组的桥体支架梁桥体面积和 SB 开口面积明显小于非支架梁桥组（p<0.05 或 p<0.01）。
短支架梁桥体间距有利于支架梁桥桥体形成，对 SB 开口处单枚支架交叉后 1 年时 SB 开口区有显著影响。
