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://dx.doi.org/10.1016/j.cjca.2013.12.016. |
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@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 = {http://dx.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://dx.doi.org/10.1016/j.cjca.2013.12.016.
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