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Dan K, Garcia-Garcia HM, Yacob O, et al. Ultra-Short Term Evaluation of Coronary Vessel Wall Changes in Reference Segments Adjacent to Culprit Lesions in ST-Segment Elevation Myocardial Infarction. J Invasive Cardiol. 2021;33(12):E923-E930
Dan, K., Garcia-Garcia, H. M., Yacob, O., Kuku, K. O., Diaz-Torres, M. A., Picchi, A., Sardella, G., Adamo, M., Frigoli, E., Limbruno, U., Rigattieri, S., Diletti, R., Boccuzzi, G., Zimarino, M., Contarini, M., Russo, F., Calabro, P., Andò, G., Varbella, F., Garducci, S., Palmieri, C., Briguori, C., Karagiannis, A., Dijkstra, J., & Valgimigli, M. (2021). Ultra-Short Term Evaluation of Coronary Vessel Wall Changes in Reference Segments Adjacent to Culprit Lesions in ST-Segment Elevation Myocardial Infarction. The Journal of invasive cardiology, 33(12), E923-E930.
Dan, Kazuhiro, et al. "Ultra-Short Term Evaluation of Coronary Vessel Wall Changes in Reference Segments Adjacent to Culprit Lesions in ST-Segment Elevation Myocardial Infarction." The Journal of invasive cardiology vol. 33,12 (2021): E923-E930.
Dan K, Garcia-Garcia HM, Yacob O, Kuku KO, Diaz-Torres MA, Picchi A, Sardella G, Adamo M, Frigoli E, Limbruno U, Rigattieri S, Diletti R, Boccuzzi G, Zimarino M, Contarini M, Russo F, Calabro P, Andò G, Varbella F, Garducci S, Palmieri C, Briguori C, Karagiannis A, Dijkstra J, Valgimigli M. Ultra-Short Term Evaluation of Coronary Vessel Wall Changes in Reference Segments Adjacent to Culprit Lesions in ST-Segment Elevation Myocardial Infarction. J Invasive Cardiol. 2021 Dec;33(12):E923-E930. Epub 2021 Nov 18. PMID: 34792483.
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J Invasive Cardiol. 2021 Dec;33(12):E923-E930. Epub 2021 Nov 18.

Ultra-Short Term Evaluation of Coronary Vessel Wall Changes in Reference Segments Adjacent to Culprit Lesions in ST-Segment Elevation Myocardial Infarction.

The Journal of invasive cardiology

Kazuhiro Dan, Hector M Garcia-Garcia, Omar Yacob, Kayode O Kuku, Miguel A Diaz-Torres, Andrea Picchi, Gennaro Sardella, Marianna Adamo, Enrico Frigoli, Ugo Limbruno, Stefano Rigattieri, Roberto Diletti, Giacomo Boccuzzi, Marco Zimarino, Marco Contarini, Filippo Russo, Paolo Calabro, Giuseppe Andò, Ferdinando Varbella, Stefano Garducci, Cataldo Palmieri, Carlo Briguori, Alexios Karagiannis, Jouke Dijkstra, Marco Valgimigli

Affiliations

  1. MedStar Washington Hospital Center, 110 Irving St NW, Washington DC USA. [email protected], [email protected].

PMID: 34792483

Abstract

BACKGROUND: Culprit lesions of ST-segment elevation myocardial infarction (STEMI) patients are friable, soft, and prone to disruption during primary percutaneous coronary intervention (pPCI). The presence of dissections in reference vessel segments (RVSs), adjacent to stented culprit lesions, and dynamic luminal changes in proximal or distal RVSs have not yet been investigated. We therefore sought to assess the healing patterns of edge dissections and the changes of lumen area at RVSs within 1 week post stent implantation in patients with STEMI.

METHODS: In the MATRIX trial (ClinicalTrials.gov NCT01433627), optical coherence tomography (OCT) was performed at the end of pPCI and within 1 week during staged PCI. The RVS dissection was defined as: type 1 = flap; type 2 = cavity; type 3 = double barrel; and type 4 = fissure. We compared separately the fate of residual dissection and luminal area/dimension by OCT in the target vessel between pPCI and staged PCI, including 1-year clinical outcomes.

RESULTS: Out of 151 patients, 46 patients had dissections in 50 RVSs and did not experience worse clinical outcome. Dissections were 44% type 1, 28% type 2, 12% type 3, and 16% type 4. Overall, 18% of the dissections healed. The mean lumen area of the RVS enlarged in 82 patients (59%) from pPCI to staged PCI. Compared with the proximal RVS, there was a significant increase in the lumen diameter at the distal RVS (0.06 ± 0.25 mm vs -0.01 ± 0.21 mm; P=.01).

CONCLUSION: Dissections occur frequently after pPCI. One-fifth of them heal within 1 week and do not seem to negatively impact clinical outcomes. Distal RVS lumen area increased compared with proximal RVS, likely reflecting a different vasoconstriction pattern over time.

Keywords: ST-segment elevation myocardial infarction; dissection; optical coherence tomography; reference vessel segment; vasoconstriction

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