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Akase, Hideaki; Okamura, Takayuki; Nagoshi, Ryoji; Fujimura, Tatsuhiro; Miyazaki, Yosuke; Takenaka, Hitoshi; Matsuyama, Tetsuya; Murasato, Yoshinobu; Yamawaki, Masahiro; Ono, Shiro; Serikawa, Takeshi; Hikichi, Yutaka; Norita, Hiroaki; Nakao, Fumiaki; Sakamoto, Tomohiro; Shinke, Toshiro; Yano, Masafumi; Shite, Junya
Circulation Journal, 2024-May-24, Letnik: 88, Številka: 6Journal Article
Background: Side branch (SB) occlusion during bifurcation stenting is a serious complication. This study aimed to predict SB compromise (SBC) using optical coherence tomography (OCT).Methods and Results: Among the 168 patients who enrolled in the 3D-OCT Bifurcation Registry, 111 bifurcation lesions were analyzed to develop an OCT risk score for predicting SBC. SBC was defined as worsening of angiographic SB ostial stenosis (≥90%) immediately after stenting. On the basis of OCT before stenting, geometric parameters (SB diameter SBd, length from proximal branching point to carina tip BP-CT length, and distance of the polygon of confluence dPOC) and 3-dimensional bifurcation types (parallel or perpendicular) were evaluated. SBC occurred in 36 (32%) lesions. The parallel-type bifurcation was significantly more frequent in lesions with SBC. The receiver operating characteristic curve indicated SBd ≤1.77 mm (area under the curve AUC=0.73, sensitivity 64%, specificity 75%), BP-CT length ≤1.8 mm (AUC=0.83, sensitivity 86%, specificity 68%), and dPOC ≤3.96 mm (AUC=0.68, sensitivity 63%, specificity 69%) as the best cut-off values for predicting SBC. To create the OCT risk score, we assigned 1 point to each of these factors. As the score increased, the frequency of SBC increased significantly (Score 0, 0%; Score 1, 8.7%; Score 2, 28%; Score 3, 58%; Score 4, 85%; P<0.0001).Conclusions: Prediction of SBC using OCT is feasible with high probability.
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JCR | SNIP | JCR | SNIP | JCR | SNIP | JCR | SNIP |
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in: SICRIS
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