Optical Coherence Tomography-Guided Primary Percutaneous
Coronary Intervention in ST-Segment Elevation Myocardial
Infarction Patients: A Pilot Study

J 2014

Optical Coherence Tomography-Guided Primary Percutaneous Coronary Intervention in ST-Segment Elevation Myocardial Infarction Patients: A Pilot Study

ČERVINKA, Pavel; Radim ŠPAČEK; Martin BYSTROŇ; Martin KVAŠŇÁK; Andrej KUPEC et al.

Základní údaje

Originální název

Optical Coherence Tomography-Guided Primary Percutaneous Coronary Intervention in ST-Segment Elevation Myocardial Infarction Patients: A Pilot Study

Autoři

ČERVINKA, Pavel; Radim ŠPAČEK; Martin BYSTROŇ; Martin KVAŠŇÁK; Andrej KUPEC; Michaela ČERVINKOVÁ a Petr KALA

Vydání

Canadian Journal of Cardiology, New York, Elsevier Science Ltd. 2014, 0828-282X

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30201 Cardiac and Cardiovascular systems

Stát vydavatele

Spojené státy

Utajení

není předmětem státního či obchodního tajemství

Impakt faktor

Impact factor: 3.711

Označené pro přenos do RIV

Ano

Kód RIV

RIV/00216224:14110/14:00078392

Organizační jednotka

Lékařská fakulta

Klíčová slova anglicky

INTRAVASCULAR ULTRASOUND; ATHEROSCLEROTIC PLAQUE; ARTERY-DISEASE; FIBROUS CAP; NO-REFLOW; THROMBUS; ANGIOPLASTY; TRIAL; PATHOGENESIS; MECHANISMS

Štítky

EL OK

Příznaky

Mezinárodní význam, Recenzováno

Změněno: 16. 1. 2015 10:26, Soňa Böhmová

Anotace

V originále

Background: The objective of our study was to assess whether optical coherence tomography (OCT) guidance could guide intervention to avoid balloon angioplasty and stenting during primary percutaneous coronary intervention. Methods: One hundred patients with ST-segment elevation myocardial infarction and thrombus-containing lesion were enrolled in this study. Thrombus aspiration was performed in all cases followed by an OCT study. After thrombectomy, no stent was implanted in residual significant stenosis (> 50%) if examination using OCT suggested that the occlusion was mostly thrombotic, provided that the patient was symptom-free and the Thrombolysis in Myocardial Infarction (TIMI) flow was >= 2. All patients managed only using thrombectomy underwent 1-week and 9-month angiography and OCT. Patients with significant lesion or those in whom thrombectomy failed to re-establish flow underwent standard treatment. Results: Based on the OCT information, 20 patients (20%) were treated only with aspiration even in the presence of angiographically detected "high-grade stenosis." Angiogram and OCT performed at 1 week and 9 months showed a "normal vessel" without significant stenosis in all 20 cases. There were no cases of major adverse cardiovascular event (including death, myocardial infarction, and target lesion revascularization) during the in-hospital period or at the 12-month follow-up. Conclusions: The results of our pilot study suggest that ST segment elevation myocardial infarction patients with TIMI 2/3 flow in the angiogram and without significant coronary narrowing using OCT examination (even in the presence of angiographically detected "high-grade stenosis"), in whom thrombus aspiration is performed in addition to optimal medical therapy might benefit only from thrombus aspiration without plain old balloon angioplasty/stenting during primary percutaneous coronary intervention. Validation of these preliminary data in larger randomized studies is warranted.

Citovat

ČERVINKA, Pavel; Radim ŠPAČEK; Martin BYSTROŇ; Martin KVAŠŇÁK; Andrej KUPEC; Michaela ČERVINKOVÁ a Petr KALA. Optical Coherence Tomography-Guided Primary Percutaneous Coronary Intervention in ST-Segment Elevation Myocardial Infarction Patients: A Pilot Study. Canadian Journal of Cardiology. New York: Elsevier Science Ltd., 2014, roč. 30, č. 4, s. 420-427. ISSN 0828-282X. Dostupné z: https://doi.org/10.1016/j.cjca.2013.12.016.

@article{1216765,
   author = {Červinka, Pavel and Špaček, Radim and Bystroň, Martin and Kvašňák, Martin and Kupec, Andrej and Červinková, Michaela and Kala, Petr},
   article_location = {New York},
   article_number = {4},
   doi = {https://doi.org/10.1016/j.cjca.2013.12.016},
   keywords = {INTRAVASCULAR ULTRASOUND; ATHEROSCLEROTIC PLAQUE; ARTERY-DISEASE; FIBROUS CAP; NO-REFLOW; THROMBUS; ANGIOPLASTY; TRIAL; PATHOGENESIS; MECHANISMS},
   language = {eng},
   issn = {0828-282X},
   journal = {Canadian Journal of Cardiology},
   title = {Optical Coherence Tomography-Guided Primary Percutaneous Coronary Intervention in ST-Segment Elevation Myocardial Infarction Patients: A Pilot Study},
   volume = {30},
   year = {2014}
}

TY  - JOUR
ID  - 1216765
AU  - Červinka, Pavel - Špaček, Radim - Bystroň, Martin - Kvašňák, Martin - Kupec, Andrej - Červinková, Michaela - Kala, Petr
PY  - 2014
TI  - Optical Coherence Tomography-Guided Primary Percutaneous Coronary Intervention in ST-Segment Elevation Myocardial Infarction Patients: A Pilot Study
JF  - Canadian Journal of Cardiology
VL  - 30
IS  - 4
SP  - 420-427
EP  - 420-427
PB  - Elsevier Science Ltd.
SN  - 0828282X
KW  - INTRAVASCULAR ULTRASOUND
KW  - ATHEROSCLEROTIC PLAQUE
KW  - ARTERY-DISEASE
KW  - FIBROUS CAP
KW  - NO-REFLOW
KW  - THROMBUS
KW  - ANGIOPLASTY
KW  - TRIAL
KW  - PATHOGENESIS
KW  - MECHANISMS
N2  - Background: The objective of our study was to assess whether optical coherence tomography (OCT) guidance could guide intervention to avoid balloon angioplasty and stenting during primary percutaneous coronary intervention. Methods: One hundred patients with ST-segment elevation myocardial infarction and thrombus-containing lesion were enrolled in this study. Thrombus aspiration was performed in all cases followed by an OCT study. After thrombectomy, no stent was implanted in residual significant stenosis (> 50%) if examination using OCT suggested that the occlusion was mostly thrombotic, provided that the patient was symptom-free and the Thrombolysis in Myocardial Infarction (TIMI) flow was >= 2. All patients managed only using thrombectomy underwent 1-week and 9-month angiography and OCT. Patients with significant lesion or those in whom thrombectomy failed to re-establish flow underwent standard treatment. Results: Based on the OCT information, 20 patients (20%) were treated only with aspiration even in the presence of angiographically detected "high-grade stenosis." Angiogram and OCT performed at 1 week and 9 months showed a "normal vessel" without significant stenosis in all 20 cases. There were no cases of major adverse cardiovascular event (including death, myocardial infarction, and target lesion revascularization) during the in-hospital period or at the 12-month follow-up. Conclusions: The results of our pilot study suggest that ST segment elevation myocardial infarction patients with TIMI 2/3 flow in the angiogram and without significant coronary narrowing using OCT examination (even in the presence of angiographically detected "high-grade stenosis"), in whom thrombus aspiration is performed in addition to optimal medical therapy might benefit only from thrombus aspiration without plain old balloon angioplasty/stenting during primary percutaneous coronary intervention. Validation of these preliminary data in larger randomized studies is warranted.
ER  -

ČERVINKA, Pavel; Radim ŠPAČEK; Martin BYSTROŇ; Martin KVAŠŇÁK; Andrej KUPEC; Michaela ČERVINKOVÁ a Petr KALA. Optical Coherence Tomography-Guided Primary Percutaneous Coronary Intervention in ST-Segment Elevation Myocardial Infarction Patients: A Pilot Study. \textit{Canadian Journal of Cardiology}. New York: Elsevier Science Ltd., 2014, roč.~30, č.~4, s.~420-427. ISSN~0828-282X. Dostupné z: https://doi.org/10.1016/j.cjca.2013.12.016.

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