Predictors for Functionally Significant In-Stent Restenosis An Integrated Analysis Using Coronary Angiography, IVUS, and Myocardial Perfusion Imaging
Predictors for Functionally Significant In-Stent Restenosis An Integrated Analysis Using Coronary Angiography, IVUS, and Myocardial Perfusion Imaging
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DOI：
10.1016/j.jcmg.2013.09.006
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发表时间：
2013-11-01
影响因子：
14
通讯作者：
Park, Seung-Jung
中科院分区：
文献类型：
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作者：
Kang, Soo-Jin;Cho, Young-Rak;Park, Seung-Jung
目的 本研究的目的是评估功能显着的支架内再狭窄 (ISR) 的临床和形态学预测因子。 背景 尽管已在自体冠状动脉病变中重新研究了它们，但 ISR 的临床和形态学特征与血流动力学意义之间的关系尚不清楚。 方法 在 175 例单支冠状动脉 ISR（血管造影狭窄 > 50%）的患者中，我们比较了定量冠状动脉造影血管内超声（IVUS）与应激心肌单光子发射计算机断层扫描（SPECT）。 SPECT 阳性表示 ISR 动脉区域存在可逆性灌注缺陷。结果 总体而言，103 名 (59%) 患者 SPEC 呈阳性。与 SPECT 阴性相比，SPEC 阳性病变的段内 IVUS 最小管腔面积 (MLA) 显着更小（1.7 +/- 0.5 mm(2) 与 2.4 +/- 0.8 mm(2)，p < 0.001）。支架扩张不足（最小支架面积
OBJECTIVES The aim of this study was to assess the clinical and morphological predictors for functionally significant in-stent restenosis (ISR).BACKGROUND Although they have been studied de novo in native coronary artery lesions, the relationships between clinical and morphological characteristics and the hemodynamic significance of ISR are not well understood.METHODS In 175 patients with ISR of a single coronary artery (angiographic stenosis >50%), we compared quantitative coronary angiography and intravascular ultrasound (IVUS) with stress myocardial single-photon emission computed tomography (SPECT). A positive SPECT was a reversible perfusion defect in the territory of the ISR artery.RESULTS Overall, 103 (59%) patients had a positive SPEC. In-segment IVUS minimal lumen area (MLA) was significantly smaller in lesions with positive SPEC compared with negative SPECT (1.7 +/- 0.5 mm(2) vs. 2.4 +/- 0.8 mm(2), p < 0.001). Stent underexpansion (minimal stent area