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支架内增强成像在冠状动脉支架置入术后决策中的价值。

Value of stent boost imaging in decision making after coronary stenting.

机构信息

Department of Cardiology, Faculty of Medicine, Aswan University, Aswan, 81528, Egypt.

Department of Cardiology, Faculty of Medicine, Cairo University, Cairo, Egypt.

出版信息

Int J Cardiovasc Imaging. 2023 Dec;39(12):2557-2566. doi: 10.1007/s10554-023-02961-4. Epub 2023 Oct 17.

Abstract

BACKGROUND

Several studies reported the comparability of digital stent enhancement techniques (including stent boost imaging) in detecting suboptimal results of coronary stenting with Intra Vascular Ultrasound and optical coherence tomography.

AIMS

to assess results of stent deployment and determine the incidence of suboptimal results requiring changing final decision using stent boost imaging.

METHODS

This cross-sectional study included 120 patients eligible for PCI were recruited during a period of one year (January 2021 to 2022) using DES.

RESULTS

Suboptimal results were found in 38% of the PCI cases with stents (angiography guided). Importantly it was found that improper lesion preparation in our practice could not help improving stent optimization. Also, angiography guided PCI has significant incidence of suboptimal results. Digital stent enhancement techniques like stent boost have significant and important value in better decision making. After adjusting for age and sex, six factors were identified as independent predictors for final decision change (stent length, LAD/RCA affection, proximal segment affection, calcification, and optical coherence tomography.

CONCLUSION

This study has confirmed the utility of stent boost for the optimization of PCI in daily practice. Stent Boost is a simple and costless technique that provides an accurate assessment of a deployed stent without extending the procedure time and without more risk. It appears to be useful for the immediate evaluation of stent expansion and optimization of PCI by additional post-dilatation, when appropriate. Future studies are needed to determine whether Stent Boost data will correlate with adverse long-term clinical outcomes in patients undergoing PCI.

摘要

背景

多项研究报告称,数字支架增强技术(包括支架增强成像)在检测冠状动脉支架置入术的不理想结果方面与血管内超声和光学相干断层成像具有可比性。

目的

评估支架置入术的结果,并确定使用支架增强成像改变最终决策的不理想结果的发生率。

方法

本横断面研究纳入了 120 例在一年内(2021 年 1 月至 2022 年)使用 DES 行 PCI 的患者。

结果

在接受 PCI 的患者中(血管造影指导),有 38%的患者出现支架置入术不理想的结果。重要的是,发现在我们的实践中,不正确的病变准备并不能帮助改善支架优化。此外,血管造影指导的 PCI 有很高的不理想结果发生率。数字支架增强技术,如支架增强,在做出更好的决策方面具有重要价值。在校正年龄和性别后,有 6 个因素被确定为最终决策改变的独立预测因素(支架长度、LAD/RCA 受累、近端节段受累、钙化和光学相干断层成像)。

结论

本研究证实了支架增强在日常 PCI 优化中的效用。支架增强是一种简单且无成本的技术,可在不延长手术时间且不增加更多风险的情况下,对已置入的支架进行准确评估。它似乎有助于在适当情况下,对支架扩张进行即时评估,并通过额外的后扩张优化 PCI。需要进一步的研究来确定支架增强数据是否与接受 PCI 的患者的不良长期临床结局相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b9f3/10692007/9d04daa573ca/10554_2023_2961_Fig1_HTML.jpg

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