Abstract 16887: Impact of Calcified Plaque Evaluated by Frequency-Domain Optical Coherence Tomography for Side-Branch Occlusion After Main-Branch Stent Implantation
Objective: We aim to evaluate, by means frequency-domain optical coherence tomography (FD-OCT), the impact of main branch (MB) calcified plaques on side branch (SB) occlusion after MB stent implantation in coronary bifurcations.
Background: Occlusion of SB after MB stent implantation is a potential concern during percutaneous coronary intervention (PCI) of coronary bifurcations as it might require additional procedures (i.e., guidewire crossing, balloon dilatation, and eventually additional stent implantation in SB ostium) while leading to ischemic compromise. Nevertheless, there is little data using FD-OCT imaging to better understand the relationship between underlying plaque and acute stent-vessel interactions in this setting.
Methods: We evaluated 78 patients with native de novo coronary bifurcation lesions with SB deserving wire protection (side-branch length greater than 50mm) who underwent MB FD-OCT before stent implantation. FD-OCT assessments were performed pre-PCI to evaluate the plaque type calcium and non-calcium (fibrous and lipid) of main branch. SB occlusion was defined as % diameter stenosis greater than 75% of SB ostium by angiogram after MB stent implantation.
Results: Occlusion of SB occurred in 43.6%- while 18 patients required balloon angioplasty for SB occlusion. In multivariable analysis, true bifurcation (odds ratio [OR]: 3.70; 95% con[[Unable to Display Character: ﬁ]]dence interval [CI]: 1.13 to 12.58; p = 0.030) and calcified plaque determined by FD-OCT assessments (OR: 17.11; 95% CI: 4.97 to 58.96; p < 0.001) were independent predictors of SB occlusion.
Conclusion: Calcified plaque demonstrated by FD-OCT assessments as well as true bifurcations were identified as independent predictors of SB occlusion after MB stent implantation.
- © 2013 by American Heart Association, Inc.