Predictive Value of NVDA Score on Minimum Lumen Area in Patients With Coronary Artery Intermediate Lesions / 中国循环杂志

Objective: Based on scores by number of vessels diseased and age (NVDA), the minimum lumen area (MLA) of left anterior descending (LAD) proximal or middle intermediate lesions were examined by intravascular ultrasound (IVUS) to analyze the clinical characteristics, to ifnd the factors affecting lumen area and to establish a scoring system for predicting MLA in relevant patients. Methods: A total of 90 patients were enrolled including 58 male and 32 female with the age of (41-77) years. The demographic information, medical history and laboratory results were studied by simple linear regression analysis to screen relevant factors affecting MLA; multi regression analysis was conducted to establish a regression equation for predicting MLA and to calculate the risk factor coefifcient for obtaining relevant scoring system. Results: NVDA score≤4 was deifned as negative result with speculated MLA≥3.0mm2, while NVDA score>4 was deifned as positive result with speculated MLA Conclusion: NVDA scoring system had the better accuracy, sensitivity and speciifcity for predicting MLA in coronary artery intermediate lesions, it had certain value for guiding coronary interventional therapy in relevant patients.

Short-term outcome of rotational atherectomy followed by drug-eluting stenting in heavily calcified ;coronary long lesions / 中国介入心脏病学杂志

Objective To investigate the safety and short-term outcome of rotational atherectomy followed by drug-eluting stenting in heavily calcified coronary long lesions. Methods From Jan 1, 2011 to May 31, 2016, 109 cases with 114 heavily calcified coronary lesions which were treated with rotational atherectomy followed by drug-eluting stenting in Peking University People's Hospital were included. They were divided into diffuse lesion group ( lesion ≥25 mm, 68 cases, 72 lesions ) and focal lesion group (lesion ﹤25 mm,41 cases, 42 lesions). All patients were followed up in hospital. Procedure parameters, procedural complications ( dissection, perforation, slow flow/no flow and procedural related myocardial infarction),procedural success and major adverse cardiovascular events (cardiac death, non-fatal myocardial infarction and stent thrombosis) were analyzed. Results The procedural success rate was 98. 5%(67/68) in diffuse lesion group and 100% ( 41/41 ) in focal lesion group ( P=0. 453 ) . Complication rates did not differ between the two groups (41. 2% and 34. 1%, P=0. 673). Major adverse cardiovascular events rates were 41. 2% and 31. 7%, P =0. 484. Conclusions Treating coronary lesions ≥25 mm in length with rotational atherectomy followed by drug-eluting stenting does not impact the short-term outcome when treating carefully and correctly . Procedural success rate and in-hospital outcome is satisfactory.

Integrated intravascular ultrasound and fractional flow reserve to guide single-stent crossover ;technique for left main and bifurcation lesions / 中国介入心脏病学杂志

Objective To investigate the relationship between the Minimum Lumen Area (MLA) and plaque burden(PB) of the left circumlfex (LCX) ostial and the occurrence of myocardial ischemia after a single stent crossover for the treatment of left main (LM) bifurcated lesions. Methods Intravascular ultrasound (IVUS) assessment was performed on 5 patients, each where coronary angiography showed left main bifurcated lesions, and to measure the MLA and PB of the LCX. Following a single stent crossover fractional lfow reserve (FFR) evaluation were performed in all 5 patients to investigate the relationship between the MLA and PB of the LCX ostium and the occurrence of myocardial ischemia. Results The mean MLA of the left main coronary of the 5 patients was (4.99±2.3) mm2 with the minimum lumen diameter (MLD) being (2.26±2.8) mm. The average MLA of the left anterior descending (LAD) ostial or proximal was (4.01±2.0) mm2, mean plaque burden (PB) at the LAD ostial or proximal was (68.15±10.1)%. Average MLA of LCX was (4.94±0.4) mm2 with a plaque burden of (66.00±6.0)%. Single stent crossover technique was used to treat the bifurcated lesions. Among the 5 patients, only 1 of them was treated with a double stent deployment where the LCX ostial FFR was0.75. Conclusions Integrated IVUS and FFR would achieve threshold measurements of MLA at LCX’s ostium which could predict ischemia after one stent strategy.

Investigation of 64-slice computed tomography angiography in diagnosis of coronary artery disease / 中国介入心脏病学杂志

0.05).Conclusion 64-slice CT provided a high diagnostic accuracy in assessing coronary artery stenosis.