Mechanisms and treatment outcomes of ostial right coronary artery in-stent restenosis.

التفاصيل البيبلوغرافية
العنوان:	Mechanisms and treatment outcomes of ostial right coronary artery in-stent restenosis.
المؤلفون:	Yamamoto K; Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York, NY, USA.; Clinical Trials Center, Cardiovascular Research Foundation, New York, NY, USA., Sato T; Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York, NY, USA.; Clinical Trials Center, Cardiovascular Research Foundation, New York, NY, USA., Salem H; Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York, NY, USA.; Clinical Trials Center, Cardiovascular Research Foundation, New York, NY, USA.; Cardiovascular Medicine Department, Faculty of Medicine - Tanta University, Tanta, Egypt., Matsumura M; Clinical Trials Center, Cardiovascular Research Foundation, New York, NY, USA., Fall KN; Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York, NY, USA., Prasad M; Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York, NY, USA., Ng VG; Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York, NY, USA., Sethi SS; Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York, NY, USA., Nazif TM; Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York, NY, USA.; Clinical Trials Center, Cardiovascular Research Foundation, New York, NY, USA., Parikh SA; Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York, NY, USA.; Clinical Trials Center, Cardiovascular Research Foundation, New York, NY, USA., Vahl TP; Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York, NY, USA.; Clinical Trials Center, Cardiovascular Research Foundation, New York, NY, USA., Ali ZA; Clinical Trials Center, Cardiovascular Research Foundation, New York, NY, USA.; St. Francis Hospital, Roslyn, NY, USA., Karmpaliotis D; Clinical Trials Center, Cardiovascular Research Foundation, New York, NY, USA.; Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown, NJ, USA., Rabbani LE; Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York, NY, USA.; Clinical Trials Center, Cardiovascular Research Foundation, New York, NY, USA., Collins MB; Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York, NY, USA., Leon MB; Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York, NY, USA.; Clinical Trials Center, Cardiovascular Research Foundation, New York, NY, USA., McEntegart MB; Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York, NY, USA.; Clinical Trials Center, Cardiovascular Research Foundation, New York, NY, USA., Moses JW; Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York, NY, USA.; Clinical Trials Center, Cardiovascular Research Foundation, New York, NY, USA., Kirtane AJ; Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York, NY, USA.; Clinical Trials Center, Cardiovascular Research Foundation, New York, NY, USA., Mintz GS; Clinical Trials Center, Cardiovascular Research Foundation, New York, NY, USA., Maehara A; Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York, NY, USA.; Clinical Trials Center, Cardiovascular Research Foundation, New York, NY, USA.
المصدر:	EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology [EuroIntervention] 2023 Aug 07; Vol. 19 (5), pp. e383-e393. Date of Electronic Publication: 2023 Aug 07.
نوع المنشور:	Journal Article
اللغة:	English
بيانات الدورية:	Publisher: Société Europa édition Country of Publication: France NLM ID: 101251040 Publication Model: Electronic Cited Medium: Internet ISSN: 1969-6213 (Electronic) Linking ISSN: 1774024X NLM ISO Abbreviation: EuroIntervention Subsets: MEDLINE
أسماء مطبوعة:	Original Publication: Toulouse : Société Europa édition, c2005-
مواضيع طبية MeSH:	Coronary Restenosis/diagnostic imaging , Coronary Restenosis/etiology , Coronary Restenosis*/therapy, Humans ; Coronary Vessels/diagnostic imaging ; Coronary Vessels/surgery ; Coronary Angiography/adverse effects ; Treatment Outcome ; Stents/adverse effects
مستخلص:	Background: Despite a high rate of in-stent restenosis (ISR) after stenting the right coronary artery (RCA) ostium, the mechanism of ostial RCA ISR is not well understood. Aims: We aimed to clarify the cause of ostial RCA ISR using intravascular ultrasound (IVUS). Methods: Overall, 139 ostial RCA ISR lesions were identified with IVUS, pre-revascularisation. Primary ISR mechanisms were classified as follows: 1) neointimal hyperplasia (NIH); 2) neoatherosclerosis; 3) ostium not covered by the stent; 4) stent fracture or deformation; 5) stent underexpansion (old minimum stent area <4.0 mm ² or stent expansion <50%); or 6) a protruding calcified nodule. Results: The median duration from prior stenting was 1.2 (first quartile 0.6, third quartile 3.1) years. The primary mechanisms of ISR were NIH in 25% (n=35) of lesions, neoatherosclerosis in 22% (n=30), uncovered ostium in 6% (n=9) (biological cause 53%, n=74), stent fracture or deformation in 25% (n=35), underexpansion in 11% (n=15), and protruding calcified nodules in 11% (n=15) (mechanical cause 47%, n=65). Including secondary mechanisms, 51% (n=71) of ostial RCA ISRs had stent fractures that were associated with greater hinge motion of the ostial-aorta angle during the cardiac cycle. The Kaplan-Meier rate of target lesion failure at 1 year was 11.5%. When the mechanically caused ISRs were treated without new stents, they suffered a higher subsequent event rate (41.4%) compared with non-mechanical causes or mechanical causes treated without restenting (7.8%, unadjusted hazard ratio 6.44, 95% confidence interval: 2.33-17.78; p<0.0001). Conclusions: Half of the ostial RCA ISRs were due to mechanical causes. Subsequent event rates were high, especially in mechanically caused ISRs treated without the implantation of a new stent.
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تواريخ الأحداث:	Date Created: 20230607 Date Completed: 20230808 Latest Revision: 20240808
رمز التحديث:	20240808
مُعرف محوري في PubMed:	PMC10397676
DOI:	10.4244/EIJ-D-23-00107
PMID:	37283548
قاعدة البيانات:	MEDLINE

الوصف
تدمد:	1969-6213
DOI:	10.4244/EIJ-D-23-00107