eISSN: 1897-4295
ISSN: 1734-9338
Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej
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2/2021
vol. 17
 
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abstract:
Original paper

Factors associated with aorto-ostial stent coverage during intravascular ultrasound-guided percutaneous coronary intervention to severely narrowed non-ostial right coronary artery lesions

Masataka Narita
1
,
Kenichi Sakakura
1
,
Yousuke Taniguchi
1
,
Kei Yamamoto
1
,
Takunori Tsukui
1
,
Masaru Seguchi
1
,
Hiroyuki Jinnouchi
1
,
Hiroshi Wada
1
,
Hideo Fujita
1

  1. Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan
Adv Interv Cardiol 2021; 17, 2 (64): 163–169
DOI: https://doi.org/10.5114/aic.2021.107494
Online publish date: 2021/07/09
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Introduction
In percutaneous coronary intervention (PCI) to atherosclerotic lesions in the right coronary artery (RCA), coronary artery dissection in the ostium of the RCA is a rare but fatal complication. Stent implantation to the ostium of RCA may be selected for the prevention of aorto-ostial dissection.

Aim
To find factors associated with aorto-ostial stent coverage to mild to moderate ostial stenosis during the treatment of severely narrowed non-ostial RCA lesions.

Material and methods
The primary interest was to find factors associated with ostial stent coverage using multivariate regression analysis. We included 236 patients who underwent intravascular ultrasound (IVUS)-guided PCI to severely narrowed RCA lesions with mild to moderate ostial stenosis, and divided those into the ostial-coverage group (n = 52) and the non-coverage group (n = 184).

Results
The prevalence of continuous ostial plaque detected by intravascular ultrasound (IVUS) was significantly greater in the ostial-coverage group (84.6%) than in the non-coverage group (52.9%) (p < 0.001). Multivariate logistic regression analysis revealed that continuous ostial plaque detected by IVUS (OR = 5.398, 95% CI: 2.322–12.553, p < 0.001) was significantly associated with ostial stent coverage after controlling confounding factors. Ischaemia-driven target vessel revascularization was less frequently observed in the ostial-coverage group than in the non-coverage group, without reaching statistical significance (p = 0.069).

Conclusions
Continuous ostial plaque detected by IVUS was significantly associated with ostial stent coverage to the mild to moderate stenosis when PCI to non-ostial, severely narrowed RCA lesions was performed. The use of IVUS may enhance the safety but may increase the total stent length in PCI to RCA.

keywords:

intravascular ultrasound, coronary imaging, target vessel revascularization
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