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Optical coherence tomography-derived predictors of stent expansion in calcified lesions.

Authors :
Ziedses des Plantes AC
Scoccia A
Neleman T
Groenland FTW
van Zandvoort LJC
Ligthart JMR
Witberg KT
Liu S
Boersma E
Nuis RJ
den Dekker WK
Wilschut J
Diletti R
Zijlstra F
Van Mieghem NM
Daemen J
Source :
Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions [Catheter Cardiovasc Interv] 2023 Jul; Vol. 102 (1), pp. 25-35. Date of Electronic Publication: 2023 May 20.
Publication Year :
2023

Abstract

Background: Severe coronary artery calcification is associated with stent underexpansion and subsequent stent failure.<br />Aims: We aimed to identify optical coherence tomography (OCT)-derived predictors of absolute (minimal stent area [MSA]) and relative stent expansion in calcified lesions.<br />Methods: This retrospective cohort study included patients who underwent percutaneous coronary intervention (PCI) with OCT assessment before and after stent implantation between May 2008 and April 2022. Pre-PCI OCT was used to assess calcium burden and post-PCI OCT was used to assess absolute and relative stent expansion.<br />Results: A total of 361 lesions in 336 patients were analyzed. Target lesion calcification (defined as OCT-detected maximum calcium angle ≥ 30°) was present in 242 (67.0%) lesions. Following PCI, median MSA was 5.37 mm <superscript>2</superscript> in calcified lesions and 6.24 mm <superscript>2</superscript> in noncalcified lesions (p < 0.001). Median stent expansion was 78% in calcified lesions and 83% in noncalcified lesions (p = 0.325). In the subset of calcified lesions, average stent diameter, preprocedural minimal lumen area, and total calcium length were independent predictors of MSA in multivariable analysis (mean difference 2.69 mm <superscript>2</superscript> /mm <superscript>2</superscript> , 0.52 mm <superscript>2</superscript> /mm, and -0.28 mm <superscript>2</superscript> /5 mm, respectively, all p < 0.001). Total stent length was the only independent predictor of relative stent expansion (mean difference -0.465% per mm, p < 0.001). Calcium angle, thickness, and the presence of nodular calcification were not significantly associated with MSA or stent expansion in multivariable analyses.<br />Conclusion: Calcium length appeared to be the most important OCT-derived predictor of MSA, whereas stent expansion was mainly determined by total stent length.<br /> (© 2023 The Authors. Catheterization and Cardiovascular Interventions published by Wiley Periodicals LLC.)

Details

Language :
English
ISSN :
1522-726X
Volume :
102
Issue :
1
Database :
MEDLINE
Journal :
Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
Publication Type :
Academic Journal
Accession number :
37210611
Full Text :
https://doi.org/10.1002/ccd.30687