Document Detail


Characterization of total occlusions with intracoronary ultrasound: the importance of the duration of occlusion.
MedLine Citation:
PMID:  11146677     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To assess the impact of the occlusion duration on the characteristics of coronary occlusive plaques. BACKGROUND: The percutaneous recanalization of chronic total coronary occlusions is a technically demanding and yet often unsuccessful procedure due to unfavorable morphological changes described by histology but not well defined in vivo. METHODS: Thirty-five consecutive total occlusions of > or = 1 month duration in previously untreated native coronary arteries were studied using intracoronary ultrasound following dilatation with a 1.5 mm balloon. Plaque characteristics of lesions with an occlusive duration of > or = 3 months (old occlusions) and those of < 3 months (recent occlusions) were then compared. The ultrasound cross-section where there was maximal plaque accumulation at the site of occlusion was analyzed for its qualitative and quantitative characteristics. The lesion remodeling index was defined as the vessel area at occlusion divided by the vessel area at a proximal reference. RESULTS: The old occlusion group comprised 11 lesions whereas 16 lesions were found in the recent occlusion group; the occlusion duration was undetermined in the remaining 8 lesions, and the mean occlusion duration was found to be 4.9 +/- 4.3 months, over a range of 1 36 months. The baseline clinical and angiographic characteristics were similar in the 2 groups. The lesion remodeling index was found to be significantly lower in older occlusions than in the more recent occlusions (0.75 +/- 0.14 vs. 1. 06 +/- 0.25; p = 0.007) and the duration of the occlusion also correlated with the length of calcified segment as determined by ultrasound (p = 0.040), and with a smaller angiographic proximal reference diameter (p = 0.043). CONCLUSION: Long-standing occlusions undergo lesion shrinkage and exhibit more extensive calcification.
Authors:
T Nishida; C Di Mario; C Briguori; R Albiero; A Colombo
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Publication Detail:
Type:  Comment; Comparative Study; Evaluation Studies; Journal Article    
Journal Detail:
Title:  The Journal of invasive cardiology     Volume:  13     ISSN:  1042-3931     ISO Abbreviation:  J Invasive Cardiol     Publication Date:  2001 Jan 
Date Detail:
Created Date:  2001-01-31     Completed Date:  2001-02-15     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8917477     Medline TA:  J Invasive Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1-8     Citation Subset:  IM    
Affiliation:
EMO Centro Cuore Columbus, Columbus Clinic and Catheterization Laboratory, San Raffaele Hospital, Via Buonarroti 48, 20145, Milan, Italy.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Chronic Disease
Coronary Angiography
Coronary Disease / radiography,  ultrasonography*
Coronary Vessels / ultrasonography*
Female
Humans
Male
Middle Aged
Prognosis
Retrospective Studies
Severity of Illness Index
Time Factors
Ultrasonography, Interventional*
Comments/Corrections
Comment On:
J Invasive Cardiol. 2001 Jan;13(1):1-8   [PMID:  11146677 ]
Comment In:
J Invasive Cardiol. 2001 Jan;13(1):1-8   [PMID:  11146677 ]
J Invasive Cardiol. 2001 Jan;13(1):9-11   [PMID:  11146678 ]

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