OCT Guidance in Bifurcation Percutaneous Coronary Intervention

Moulias, Athanasios; Koros, Rafail; Papageorgiou, Angeliki; Patrinos, Panagiotis; Spyropoulou, Panagiota; Vakka, Angeliki; Bozika, Maria; Vasilagkos, Georgios; Toutouzas, Konstantinos; Nastouli, Kassiani-Maria; Tsigkas, Grigorios; Davlouros, Periklis

doi:10.31083/j.rcm2403088

Cited by 2 publications

(2 citation statements)

References 38 publications

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“…Consequently, there has been a consistent augmentation in the rates of successful chronic total occlusion revascularization. As supported by Zein et al, the comprehensive procedural success rate exhibited an enhancement from 45% in 2010 to 55% in 2017 [41]. More recent data from the PROGRESS-CTO International Registry showed an increased success rate over time, from 81.6% in 2016 to 88.1% in 2021 (p < 0.0001) [42].…”

Section: Discussionmentioning

confidence: 80%

Efficacy and Safety of Thirty-Day Dual-Antiplatelet Therapy Following Complex Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis

Apostolos,

Chlorogiannis,

Chrysostomidis

et al. 2024

JCDD

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The optimal duration of DAPT after complex PCI remains under investigation. The purpose of this systematic review and meta-analysis was to explore the safety and efficacy of a one-month therapy period versus a longer duration of DAPT after complex PCI. We systematically screened three major databases, searching for randomized controlled trials or sub-analyses of them, which compared shortened DAPT (S-DAPT), namely, one month, and longer DAPT (L-DAPT), namely, more than three months. The primary endpoint was any Net Adverse Clinical Event (NACE), and the secondary was any MACE (Major Adverse Cardiac Event), its components (mortality, myocardial infarction, stroke, and stent thrombosis), and major bleeding events. Three studies were included in the analysis, with a total of 6275 patients. Shortening DAPT to 30 days after complex PCI did not increase the risk of NACEs (OR: 0.77, 95% CI: 0.52–1.14), MACEs, mortality, myocardial infractions, stroke, or stent thrombosis. Pooled major bleeding incidence was reduced, but this finding was not statistically significant. This systematic review and meta-analysis showed that one-month DAPT did not differ compared to a longer duration of DAPT after complex PCI in terms of safety and efficacy endpoints. Further studies are still required to confirm these findings.

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Section: Discussionmentioning

confidence: 80%

Efficacy and Safety of Thirty-Day Dual-Antiplatelet Therapy Following Complex Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis

Apostolos,

Chlorogiannis,

Chrysostomidis

et al. 2024

JCDD

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“…Another issue concerns coronary bifurcation lesions, which are the stenosis of the coronary artery near the origin of a major side branch. They occur in 15-20% of performed PCI, and because of traditional angiography's limitations, are associated with poorer procedural success rates and a greater risk of adverse events [50]. The use of intravascular imaging helps to properly guide the PCI device (Table 1) and ensures immediate improvement of the procedure, as well as providing better long-term outcomes [49].…”

Section: Intravascular Imaging In Ra Oa and Ivlmentioning

confidence: 99%

Rotational Atherectomy, Orbital Atherectomy, and Intravascular Lithotripsy Comparison for Calcified Coronary Lesions

Florek,

Bartoszewska,

Biegała

et al. 2023

JCM

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In order to improve the percutaneous treatment of coronary artery calcifications (CAC) before stent implantation, methods such as rotational atherectomy (RA), orbital atherectomy (OA), and coronary intravascular lithotripsy (IVL) were invented. These techniques use different mechanisms of action and therefore have various short- and long-term outcomes. IVL employs sonic waves to modify CAC, whereas RA and OA use a rapidly rotating burr or crown. These methods have specific advantages and limitations, regarding their cost-efficiency, the movement of the device, their usefulness given the individual anatomy of both the lesion and the vessel, and the risk of specified complications. This study reviews the key findings of peer-reviewed articles available on Google Scholar with the keywords RA, OA, and IVL. Based on the collected data, successful stent delivery was assessed as 97.7% for OA, 92.4% for IVL, and 92.5% for RA, and 30-day prevalence of MACE (Major Adverse Cardiac Events) in OA—10.4%, IVL—7.2%, and RA—5%. There were no significant differences in the 1-year MACE. Compared to RA, OA and IVL are cost-effective approaches, but this is substantially dependent on the reimbursement system of the particular country. There is no standard method of CAC modification; therefore, a tailor-made approach is required.

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OCT Guidance in Bifurcation Percutaneous Coronary Intervention

Cited by 2 publications

References 38 publications

Efficacy and Safety of Thirty-Day Dual-Antiplatelet Therapy Following Complex Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis

Efficacy and Safety of Thirty-Day Dual-Antiplatelet Therapy Following Complex Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis

Rotational Atherectomy, Orbital Atherectomy, and Intravascular Lithotripsy Comparison for Calcified Coronary Lesions

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