Details

Autor(en) / Beteiligte

• Yamamoto, Kei
• Sugizaki, Yoichiro
• Karmpaliotis, Dimitri
• Sato, Takao
• Matsumura, Mitsuaki
• Narui, Shuro
• Yamamoto, Myong Hwa
• Fall, Khady N.
• James, Elizabeth I.
• Glinski, John B.
• Rabban, Maya L.
• Prasad, Megha
• Ng, Vivian G.
• Sethi, Sanjum S.
• Nazif, Tamim M.
• Parikh, Sahil A.
• Vahl, Torsten P.
• Ali, Ziad A.
• Rabbani, LeRoy E.
• Collins, Michael B.
• Leon, Martin B.
• McEntegart, Margaret
• Moses, Jeffrey W.
• Kirtane, Ajay J.
• Ochiai, Masahiko
• Mintz, Gary S.
• Maehara, Akiko

Titel

Presence and Relevance of Myocardial Bridge in LAD-PCI of CTO and Non-CTO Lesions

Ist Teil von

• JACC. Cardiovascular interventions, 2024-02, Vol.17 (4), p.491-501

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2024

Quelle

MEDLINE

Beschreibungen/Notizen

• Intravascular ultrasound (IVUS) studies show that one-quarter of left anterior descending (LAD) arteries have a myocardial bridge. An MB may be associated with stent failure when the stent extends into the MB. The aim of this study was to investigate: 1) the association between an MB and chronic total occlusion (CTO) in any LAD lesions; and 2) the association between an MB and subsequent clinical outcomes after percutaneous coronary intervention in LAD CTOs. A total of 3,342 LAD lesions with IVUS-guided percutaneous coronary intervention (280 CTO and 3,062 non-CTO lesions) were included. The primary outcome was target lesion failure (cardiac death, target vessel myocardial infarction, definite stent thrombosis, and ischemic-driven target lesion revascularization). An MB by IVUS was significantly more prevalent in LAD CTOs than LAD non-CTOs (40.4% [113/280] vs 25.8% [789/3,062]; P < 0.0001). The discrepancy in CTO length between angiography and IVUS was greater in 113 LAD CTOs with an MB than 167 LAD CTOs without an MB (6.0 [Q1, Q3: 0.1, 12.2] mm vs 0.2 [Q1, Q3: −1.4, 8.4] mm; P < 0.0001). Overall, 48.7% (55/113) of LAD CTOs had a stent that extended into an MB after which target lesion failure was significantly higher compared to a stent that did not extend into an MB (26.3% vs 0%; P = 0.0004) or compared to an LAD CTO without an MB (26.3% vs 9.6%; P = 0.02). An MB was more common in LAD CTO than non-CTO LAD lesions. If present, approximately one-half of LAD CTOs had a stent extending into an MB that, in turn, was associated with worse outcomes. [Display omitted]