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KMID : 0882420040670020153
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Korean Journal of Medicine
2004 Volume.67 No. 2 p.153 ~ p.160
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Predictors of side branch occlusions just after coronary stenting
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Seo Young-Uk
Koh Young-Youp
Kang Min-Jung
Chang Kyoung-Sig
Hong Soon-Pyo
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Abstract
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Background: Coronary stenting is one of effective and well-accepted treatments for coronary artery disease. On the other hand, side branch occlusion (SBO) is a known complication of percutaneous transluminal coronary angioplasty (PTCA) and coronary stenting. Accordingly, this study was designed to determine the incidence, predictors and acute clinical outcomes of SBO.
Methods: Coronary angiographic findings of 45 patients who had total 98 side branches originating from the stented segments were analized before and just after coronary stenting. Bifurcation lesions were divided into 3 types : type 1, type 2, type 3 and each type was subdivided into type A with significant ostial narrowing (diameter stenosis ≥50%) and type B without significant ostial narrowing of side branches. Side branch occlusion was defined as development of
total occlusion or morphologic changes from type B to type A or reduction of TIMI flow more than grade 1 compared with pre-stenting flow of side branches.
Results: After coronary stenting, SBO occurred in 20 of 98 side branches (20.4%). SBO was significantly related with history of previous myocardial infarction (p=0.02), threatened side branch morphology (p=0.016) and poor pre-stenting flow of side branches (p=0.014). There were no serious clinical events such as myocardial infaction and death associated with acute SBO.
Conclusion: Acute SBO can be developed in a few stented patients. Signifiant clinical and angiographic predictors of SBO just after coronary stenting were the history of previous myocardial infarction, threatened side branch morphology and poor pre-stenting flow of side branches.(Korean J Med 67:153-160, 2004)
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KEYWORD
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Coronary stenosis, Stent
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