Intimal flaps detected by optical frequency domain imaging in the proximal segments of native coronary arteries

An innocent bystander? insights from the TROFI trial

Takashi Muramatsu, Hector M. García-García, Yoshinobu Onuma, Yao Jun Zhang, Christos V. Bourantas, Roberto Diletti, Javaid Iqbal, Maria D. Radu, Yukio Ozaki, Patrick W. Serruys

研究成果: Article

8 引用 (Scopus)

抄録

Background: The prevalence and clinical sequelae of optical frequency domain imaging (OFDI)-detected intimal flaps caused by vessel trauma or plaque rupture in the proximal native coronary arteries have not been described. Methods and Results: OFDI investigation was performed following stent implantation in patients with ST-segment elevation myocardial infarction (STEMI). We defined a flap-like structure (FS) as a disruption or discontinuation of the endoluminal vessel surface, and classified as actual flap or artifact. FS in the left main stem, or maximally 20 mm distal to the guiding catheter in the proximal right coronary artery were assessed. A total of 8,931 frames in 97 patients were analyzed in a frame-by-frame fashion (0.125-mm interval). OFDI identified 8 FS in 7 patients, none of which was evident angiographically. All FS were left untreated because the operators per protocol were blinded to the OFDI images. A total of 5 FS in 5 patients (5.1%) appeared to be actual flaps in which only the intima was involved (mean distance from guiding catheter: 4.8±2.7 mm). The remaining 3 FS in 3 patients were artifacts; namely, residual blood and interface light reflectivity. There were no adverse cardiac events during 6-months follow-up. Conclusions: In 5.1% of STEMI patients, post-procedural OFDI identified flaps with minimal involvement of the intima in the proximal coronary arteries. A precise interpretation of FS may help decision making to avoid unnecessary procedures.

元の言語English
ページ(範囲)2327-2333
ページ数7
ジャーナルCirculation Journal
77
発行部数9
DOI
出版物ステータスPublished - 28-08-2013

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Tunica Intima
Coronary Vessels
Artifacts
Catheters
Unnecessary Procedures
Stents
Rupture
Decision Making
Myocardial Infarction
Light
Wounds and Injuries

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

これを引用

Muramatsu, Takashi ; García-García, Hector M. ; Onuma, Yoshinobu ; Zhang, Yao Jun ; Bourantas, Christos V. ; Diletti, Roberto ; Iqbal, Javaid ; Radu, Maria D. ; Ozaki, Yukio ; Serruys, Patrick W. / Intimal flaps detected by optical frequency domain imaging in the proximal segments of native coronary arteries : An innocent bystander? insights from the TROFI trial. :: Circulation Journal. 2013 ; 巻 77, 番号 9. pp. 2327-2333.
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title = "Intimal flaps detected by optical frequency domain imaging in the proximal segments of native coronary arteries: An innocent bystander? insights from the TROFI trial",
abstract = "Background: The prevalence and clinical sequelae of optical frequency domain imaging (OFDI)-detected intimal flaps caused by vessel trauma or plaque rupture in the proximal native coronary arteries have not been described. Methods and Results: OFDI investigation was performed following stent implantation in patients with ST-segment elevation myocardial infarction (STEMI). We defined a flap-like structure (FS) as a disruption or discontinuation of the endoluminal vessel surface, and classified as actual flap or artifact. FS in the left main stem, or maximally 20 mm distal to the guiding catheter in the proximal right coronary artery were assessed. A total of 8,931 frames in 97 patients were analyzed in a frame-by-frame fashion (0.125-mm interval). OFDI identified 8 FS in 7 patients, none of which was evident angiographically. All FS were left untreated because the operators per protocol were blinded to the OFDI images. A total of 5 FS in 5 patients (5.1{\%}) appeared to be actual flaps in which only the intima was involved (mean distance from guiding catheter: 4.8±2.7 mm). The remaining 3 FS in 3 patients were artifacts; namely, residual blood and interface light reflectivity. There were no adverse cardiac events during 6-months follow-up. Conclusions: In 5.1{\%} of STEMI patients, post-procedural OFDI identified flaps with minimal involvement of the intima in the proximal coronary arteries. A precise interpretation of FS may help decision making to avoid unnecessary procedures.",
author = "Takashi Muramatsu and Garc{\'i}a-Garc{\'i}a, {Hector M.} and Yoshinobu Onuma and Zhang, {Yao Jun} and Bourantas, {Christos V.} and Roberto Diletti and Javaid Iqbal and Radu, {Maria D.} and Yukio Ozaki and Serruys, {Patrick W.}",
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Muramatsu, T, García-García, HM, Onuma, Y, Zhang, YJ, Bourantas, CV, Diletti, R, Iqbal, J, Radu, MD, Ozaki, Y & Serruys, PW 2013, 'Intimal flaps detected by optical frequency domain imaging in the proximal segments of native coronary arteries: An innocent bystander? insights from the TROFI trial', Circulation Journal, 巻. 77, 番号 9, pp. 2327-2333. https://doi.org/10.1253/circj.CJ-13-0357

Intimal flaps detected by optical frequency domain imaging in the proximal segments of native coronary arteries : An innocent bystander? insights from the TROFI trial. / Muramatsu, Takashi; García-García, Hector M.; Onuma, Yoshinobu; Zhang, Yao Jun; Bourantas, Christos V.; Diletti, Roberto; Iqbal, Javaid; Radu, Maria D.; Ozaki, Yukio; Serruys, Patrick W.

:: Circulation Journal, 巻 77, 番号 9, 28.08.2013, p. 2327-2333.

研究成果: Article

TY - JOUR

T1 - Intimal flaps detected by optical frequency domain imaging in the proximal segments of native coronary arteries

T2 - An innocent bystander? insights from the TROFI trial

AU - Muramatsu, Takashi

AU - García-García, Hector M.

AU - Onuma, Yoshinobu

AU - Zhang, Yao Jun

AU - Bourantas, Christos V.

AU - Diletti, Roberto

AU - Iqbal, Javaid

AU - Radu, Maria D.

AU - Ozaki, Yukio

AU - Serruys, Patrick W.

PY - 2013/8/28

Y1 - 2013/8/28

N2 - Background: The prevalence and clinical sequelae of optical frequency domain imaging (OFDI)-detected intimal flaps caused by vessel trauma or plaque rupture in the proximal native coronary arteries have not been described. Methods and Results: OFDI investigation was performed following stent implantation in patients with ST-segment elevation myocardial infarction (STEMI). We defined a flap-like structure (FS) as a disruption or discontinuation of the endoluminal vessel surface, and classified as actual flap or artifact. FS in the left main stem, or maximally 20 mm distal to the guiding catheter in the proximal right coronary artery were assessed. A total of 8,931 frames in 97 patients were analyzed in a frame-by-frame fashion (0.125-mm interval). OFDI identified 8 FS in 7 patients, none of which was evident angiographically. All FS were left untreated because the operators per protocol were blinded to the OFDI images. A total of 5 FS in 5 patients (5.1%) appeared to be actual flaps in which only the intima was involved (mean distance from guiding catheter: 4.8±2.7 mm). The remaining 3 FS in 3 patients were artifacts; namely, residual blood and interface light reflectivity. There were no adverse cardiac events during 6-months follow-up. Conclusions: In 5.1% of STEMI patients, post-procedural OFDI identified flaps with minimal involvement of the intima in the proximal coronary arteries. A precise interpretation of FS may help decision making to avoid unnecessary procedures.

AB - Background: The prevalence and clinical sequelae of optical frequency domain imaging (OFDI)-detected intimal flaps caused by vessel trauma or plaque rupture in the proximal native coronary arteries have not been described. Methods and Results: OFDI investigation was performed following stent implantation in patients with ST-segment elevation myocardial infarction (STEMI). We defined a flap-like structure (FS) as a disruption or discontinuation of the endoluminal vessel surface, and classified as actual flap or artifact. FS in the left main stem, or maximally 20 mm distal to the guiding catheter in the proximal right coronary artery were assessed. A total of 8,931 frames in 97 patients were analyzed in a frame-by-frame fashion (0.125-mm interval). OFDI identified 8 FS in 7 patients, none of which was evident angiographically. All FS were left untreated because the operators per protocol were blinded to the OFDI images. A total of 5 FS in 5 patients (5.1%) appeared to be actual flaps in which only the intima was involved (mean distance from guiding catheter: 4.8±2.7 mm). The remaining 3 FS in 3 patients were artifacts; namely, residual blood and interface light reflectivity. There were no adverse cardiac events during 6-months follow-up. Conclusions: In 5.1% of STEMI patients, post-procedural OFDI identified flaps with minimal involvement of the intima in the proximal coronary arteries. A precise interpretation of FS may help decision making to avoid unnecessary procedures.

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DO - 10.1253/circj.CJ-13-0357

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