Impact of multiple ballooning on coronary lesions as assessed by optical coherence tomography and intravascular ultrasound

IF 2.1 3区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Catheterization and Cardiovascular Interventions Pub Date : 2024-09-22 DOI:10.1002/ccd.31239

Yusuke Kanzaki MD, Yasushi Ueki MD, PhD, Daisuke Sunohara MD, Yoshiteru Okina MD, Hidetomo Nomi MD, PhD, Keisuke Machida MD, Daisuke Kashiwagi MD, PhD, Hidetsugu Yoda MD, Shusaku Maruyama MD, PhD, Ayumu Nagae MD, Tamon Kato MD, PhD, Tatsuya Saigusa MD, PhD, Jouke Dijkstra PhD, Soichiro Ebisawa MD, PhD, Koichiro Kuwahara MD, PhD

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Abstract

Background

Optimal lesion preparation for coronary lesions has been reappraised in the interventional community, given the increasing use of drug-coated balloons for de novo lesions; however, whether multiple ballooning could achieve more favorable angiographic results compared with single ballooning remains unknown. We aimed to investigate the incremental effect of multiple ballooning on de novo coronary lesions over single ballooning as assessed by optical coherence tomography (OCT) and intravascular ultrasound (IVUS) among patients undergoing percutaneous coronary intervention (PCI).

Methods

Patients with chronic coronary syndrome (CCS) undergoing PCI were enrolled. Ballooning before stent implantation was repeatedly performed for three times using the same semi-compliant balloon. OCT and IVUS were performed after each balloon dilatation. Primary outcome measure was the difference in the mean lumen area between post-1st ballooning (1B) and post-3rd ballooning (3B) as assessed by OCT.

Results

A total of 32 lesions in 30 patients undergoing PCI between May 2021 and August 2022 were analyzed. Major plaque types of the lesions were fibrous (68.8%) and lipid (28.1%). Mean lumen area by OCT was significantly increased from 1B to 3B (5.9 ± 2.9 mm² vs. 6.0 ± 2.9 mm², difference: 0.2 ± 0.4 mm², p = 0.040). There were significant increases from 1B to 3B in minimum lumen area by OCT (3.1 ± 1.5 mm² vs. 3.6 ± 1.7 mm², difference: 0.5 ± 0.6 mm², p < 0.001) and mean dissection angle by OCT (65.6 ± 24.9° vs. 95.2 ± 34.0°, difference: 29.6 ± 25.5°, p < 0.001). Additionally, mean plaque area by IVUS was significantly decreased (8.0 ± 4.2 mm² vs. 7.8 ± 4.1 mm², difference: −0.2 ± 0.2 mm², p < 0.001).

Conclusions

Among CCS patients with mainly non-calcified lesions, multiple ballooning significantly increased the lumen area and dissection angle compared with single ballooning.

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通过光学相干断层扫描和血管内超声评估多重气球对冠状动脉病变的影响。

背景：鉴于药物涂层球囊越来越多地用于治疗新发病变，介入治疗界对冠状动脉病变的最佳病变准备进行了重新评估；然而，与单次球囊置入相比，多次球囊置入是否能获得更有利的血管造影结果仍是未知数。我们的目的是研究在接受经皮冠状动脉介入治疗（PCI）的患者中，通过光学相干断层扫描（OCT）和血管内超声（IVUS）评估多次球囊扩张对新发冠状动脉病变的增量效果：方法：入组接受经皮冠状动脉介入治疗的慢性冠状动脉综合征（CCS）患者。使用相同的半顺应性球囊反复进行三次支架植入前的球囊扩张。每次球囊扩张后进行 OCT 和 IVUS 检查。主要结果指标是 OCT 评估的第 1 次球囊扩张后（1B）和第 3 次球囊扩张后（3B）的平均管腔面积差异：对2021年5月至2022年8月期间接受PCI手术的30名患者的32个病变进行了分析。病变的主要斑块类型为纤维斑块（68.8%）和脂质斑块（28.1%）。OCT 显示的平均管腔面积从 1B 到 3B 显著增加（5.9 ± 2.9 mm2 vs. 6.0 ± 2.9 mm2，差异：0.2 ± 0.4 mm2，p = 0.040）。通过 OCT 检测，最小管腔面积从 1B 到 3B 有明显增加（3.1 ± 1.5 mm2 vs. 3.6 ± 1.7 mm2，差异：0.5 ± 0.6 mm2，p = 0.040）：3.1 ± 1.5 mm2 vs. 3.6 ± 1.7 mm2，差异：0.5 ± 0.6 mm2，P 2 vs. 7.8 ± 4.1 mm2，差异：-0.2 ± 0.2 mm2：-结论：在以非钙化病变为主的 CCS 患者中，与单个球囊扩张相比，多个球囊扩张可显著增加管腔面积和夹层角度。

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来源期刊

Catheterization and Cardiovascular Interventions 医学-心血管系统

CiteScore

5.40

自引率

8.70%

发文量

419

审稿时长

2 months

期刊介绍： Catheterization and Cardiovascular Interventions is an international journal covering the broad field of cardiovascular diseases. Subject material includes basic and clinical information that is derived from or related to invasive and interventional coronary or peripheral vascular techniques. The journal focuses on material that will be of immediate practical value to physicians providing patient care in the clinical laboratory setting. To accomplish this, the journal publishes Preliminary Reports and Work In Progress articles that complement the traditional Original Studies, Case Reports, and Comprehensive Reviews. Perspective and insight concerning controversial subjects and evolving technologies are provided regularly through Editorial Commentaries furnished by members of the Editorial Board and other experts. Articles are subject to double-blind peer review and complete editorial evaluation prior to any decision regarding acceptability.