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Plaque characteristics and slow flow during percutaneous coronary intervention of irregular protrusion by optical coherence tomography

  • Hideo AmanoEmail author
  • Ryota Noike
  • Daiga Saito
  • Takayuki Yabe
  • Ippei Watanabe
  • Ryo Okubo
  • Masayuki Koizumi
  • Mikihito Toda
  • Takanori Ikeda
Original Article
  • 42 Downloads

Abstract

Irregular protrusion on optical coherence tomography (OCT) is associated with clinical events and target lesion revascularization. We investigated clinical and procedure characteristics, plaque characteristics, slow flow after stent implantation, and clinical outcomes with irregular protrusion using OCT. Eighty-four lesions in 76 patients undergoing OCT before percutaneous coronary intervention were evaluated. Irregular protrusion was defined as protrusion of material with an irregular surface into the lumen between stent struts with a maximum height of ≥100 μm. Lesions with irregular protrusion were found in 56% (47/84). Compared with lesions without irregular protrusion, those with irregular protrusion had significantly higher low-density lipoprotein cholesterol (LDL-C) levels (108 ± 31 mg/dl vs. 95 ± 25 mg/dl, P = 0.044); a tendency toward decreased use of statins [44% (19/43) vs. 67% (22/33), P = 0.065]; significantly larger reference vessel diameter (3.12 ± 0.53 mm vs. 2.74 ± 0.63 mm, P = 0.004); more frequent slow flow after stent implantation [38% (18/47) vs. 11% (4/37), P = 0.006]; higher incidence of thin-cap fibroatheromas [TCFAs; 49% (23/47) vs. 5% (2/37), P < 0.001]; plaque rupture [40% (19/47) vs. 16% (6/37), P = 0.018]; and a tendency higher incidence of 1-year adverse clinical outcomes (death, acute myocardial infarction, acute coronary syndrome, or target lesion revascularization) [12% (5/43) vs. 0% (0/33), P = 0.075]. In conclusion, irregular protrusion on OCT was associated with high plaque vulnerability, higher LDL-C, less frequent use of statin, larger vessel diameter, slow flow after stent implantation, and 1-year adverse clinical outcomes.

Keywords

Irregular protrusion Optical coherence tomography Slow flow 

Notes

Compliance with ethical standards

Conflict of interest

The authors do not have any potential conflicts of interest associated with this paper.

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Copyright information

© Springer Japan KK, part of Springer Nature 2019

Authors and Affiliations

  • Hideo Amano
    • 1
    Email author
  • Ryota Noike
    • 1
  • Daiga Saito
    • 1
  • Takayuki Yabe
    • 1
  • Ippei Watanabe
    • 1
  • Ryo Okubo
    • 1
  • Masayuki Koizumi
    • 1
  • Mikihito Toda
    • 1
  • Takanori Ikeda
    • 1
  1. 1.Department of Cardiovascular MedicineToho University Faculty of MedicineTokyoJapan

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