Title The effectiveness of myocardial revascularization in patients with diffuse coronary atherosclerosis /
Translation of Title Miokardo revaskuliarizacijos efektyvumo įvertinimas vyraujant difuziniam ateroskleroziniam širdies vainikinių arterijų pažeidimui.
Authors Baranauskas, Arvydas
Full Text Download
Pages 38
Keywords [eng] coronary artery disease ; fractional flow reserve ; long stents
Abstract [eng] There is still a controversy in the treatment of long coronary lesions. In case of diffuse coronary artery disease the optimal extent of revascularization is not well established and is usually operator dependent. The aim of this study was to evaluate functional, angiographic and clinical results of fractional flow reserve (FFR) guided percutaneous coronary intervention (PCI) on long coronary lesions using 2nd or newer generation drug eluting stents (DES). Patients were included if they had a lesion in a major coronary vessel where FFR value was ≤ 0.8 and it was envisaged that a stent ≥ 30 mm in length would be necessary. Achieving an optimal post PCI FFR result in patients with long diffuse coronary artery disease was only possible in a limited number of cases equating to 12.2%. An optimal FFR result could not be achieved in any patient who was treated with >50 mm of stent. The use of long and ultra-long stents resulted in a high proportion of patents with residual hemodynamically significant ischemia (10.8% of cases with post PCI FFR ≤ 0.80). The rate of functional restenosis at 9 months follow up was shown to be approximately 3 times higher than angiographic restenosis. In the majority of cases diffuse coronary artery disease cannot be functionally effectively treated using long and ultra-long drug eluting stents. PCI on long coronary lesions could be used as an option in the high CABG risk patients with diffuse coronary artery disease.
Dissertation Institution Vilniaus universitetas.
Type Summaries of doctoral thesis
Language English
Publication date 2017