Document Detail


Radiofrequency-Intravascular Ultrasound Assessment of Lesion Coverage After Angiography-Guided Emergent Percutaneous Coronary Intervention in Patients With Non-ST Elevation Myocardial Infarction.
MedLine Citation:
PMID:  24063826     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Using radiofrequency-intravascular ultrasound (VH-IVUS), we have previously demonstrated that in 50% of patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention with optimal angiographic result, the stent does not fully cover the whole VH-IVUS-derived thin-cap fibroatheroma (VH-TCFA) related to the culprit lesion. Presently, we set out to extend these findings to 20 patients with non-STEMI with Thrombolysis In Myocardial Infarction flow 3 in the infarct-related artery before intervention who were then treated with angiography-guided direct stent implantation. The lesion was imaged with VH-IVUS before and after intervention, but the results were blinded to the operator. Plaque rupture site was identified in 8 lesions (40%), all proximal to the minimum lumen area (MLA) site. The maximum necrotic core site was found proximal to MLA in 18 lesions and at the MLA in 2 lesions. Although the plaque rupture site was fully covered with the stent in all lesions, an uncovered VH-TCFA was found in 7 lesions (35%), 4 in the proximal reference segment, 1 in the distal reference segment, and 2 in both the proximal and distal reference segments. In conclusion, in 35% of patients with non-STEMI undergoing angiography-guided emergent percutaneous coronary intervention, the stent does not fully cover a VH-TCFA related to the culprit lesion.
Authors:
Jacek Legutko; Jacek Jakala; Gary S Mintz; Grzegorz L Kaluza; Blaz Mrevlje; Lukasz Partyka; Marcin Wizimirski; Lukasz Rzeszutko; Angela Richter; Pauliina Margolis; Dariusz Dudek
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-9-21
Journal Detail:
Title:  The American journal of cardiology     Volume:  -     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2013 Sep 
Date Detail:
Created Date:  2013-9-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2013 Elsevier Inc. All rights reserved.
Affiliation:
2nd Department of Cardiology, Faculty of Medicine, Jagiellonian University Medical College and University Hospital, Cracow, Poland.
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