intravascular ultrasound

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Research Letter

Out of Sight, Out of Heart?

Costantino Roberto Costantini et al. Costantino Ortiz Costantini Sérgio Gustavo Tarbine Marcos Antonio Denk … Vinicius Shibata Ferrari Rafael Michel de Macedo

In December 1987, with over 300 experimental coronary implants performed in dogs and cadavers, Palmaz and Schatz, accompanied by Dr. Eduardo Sousa (Dante Pazzanese Cardiology Institute), performed the first human stent implantation in São Paulo, with a prosthesis developed by Palmaz himself.

However, the initial results of the first multicenter study on the subject were less than encouraging, as the device showed high rates of subacute occlusion (18%), despite the Palmaz stent presenting numerous favorable aspects of biocompatibility, mechanics, and hemodynamics.

[…]

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Artigo Original

Late outcome of sirolimus-eluting stents: comparison of multidetector computed tomography with quantitative coronary angiography and intravascular ultrasound

Ibraim Masciarelli F. Pinto et al. Amanda G. M. R. Sousa Walther Ishikama Luiz Alberto Mattos … Alexandre Abizaid Fausto Feres Luiz Fernando L. Tanajura Luiz C. B. Sousa J. Eduardo M. R. Sousa Adib Jatene

OBJECTIVE: To assess the performance of multidetector computed tomography in determining late clinical outcomes of patients undergoing sirolimus-eluting stent implantation. METHODS: Thirty patients, successfully submitted to sirolimus-eluting stent implantation for more than six months, were selected to participate in the study. All underwent invasive angiography and intravascular ultrasound following CT angiography using iodinated contrast medium at a dose of 1.5 ml/kg. RESULTS: Mean proximal reference diameter was 3.01 ± 0.31 mm by tomography and 3.14 ± 0.31 mm by angiography (p = 0.04). When the left circumflex artery was excluded from the analysis, the difference between both examinations was no longer significant (tomography = 3.01 ± 0.32 mm; angiography = 3.10 ± 0.30 mm, p = 0.65). Mean distal reference diameter was 2.86 ± 0.30 mm by tomography and 2.92 ± 0.32 by angiography (p = 0.25). Mean in-stent minimal lumen diameter was 2.85 ± 0.25 mm by tomography and 2.85 ± 0.29 mm by angiography (p = 0.27). Mean minimal in-stent cross-sectional area was 7.19 ± 1.47 mm² by tomography and 6.90 ± 1.52 mm² by intravascular ultrasound (p = 0.36), but there was only a weak correlation between these measurements (r = 0.33). CONCLUSION: Computed tomography allows the qualitative assessment of sirolimus-eluting stents, accurate estimate of proximal and distal reference diameters of the target vessel, and in-stent minimal lumen diameter. Its correlation with measurements performed using intravascular ultrasound, however, is less strong.

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Artigo Original

The use of intravascular ultrasound in deciding on the treatment of moderate coronary lesions

Andrea Claudia Leão de Sousa Abizaid et al. Leopoldo Soares Piegas Alexandre Antonio Cunha Abizaid Luiz Fernando Leite Tanajura … Aurea Jacob Chaves Marinella Patrizia Centemero Ana Cristina C. Seixas Luiz Alberto Piva Mattos Ibraim Pinto Amanda Guerra Morais Rego Sousa J. Eduardo Morais Rego Sousa

OBJECTIVE: To investigate the ultrasound criterion of minimum luminal area (MLA) with a cutoff value of 4.0 mm² in an attempt to differentiate the lesions that should be treated from those that should not. METHODS: The study comprised 173 consecutive patients with moderate angiographic lesions (percentage of stenosis between 40 and 70) who underwent ultrasound imaging. They were divided into 2 groups as follows: group 1 or clinical group (MLA > 4.0 mm²); and group 2 or revascularization group (MLA 4.0 mm² and were clinically treated; 98 (57%) patients had MLA < 4.0 mm² and were treated with coronary stents. On quantitative coronary angiography, no significant difference was observed between the percentage of vessel stenosis [group 1: 48% vs group 2: 53%; P=0.06]. By the other hard ultrasound measurements, as MLA was significantly greater in group 1 compared with that in group 2 [4.54 mm² vs 2.45 mm²; P < 0.001)]. The clinical impact of the decision was favorable, and no difference was observed in regard to the occurrence of major cardiac events: [group 1: 5 (7%) vs group 2: 14 (15%); P = 0.09]. The need for revascularization of the target lesion also did not differ (group 1: 3 (4%) vs group 2: 11 (12%); P = 0.07). The predictive variables for MCE were diabetes, functional class III (FC III) angina before hospitalization, and MLA assessed on ultrasound. CONCLUSION: This strategy for deciding on appropriate treatment guarantees low rates of MCE in both groups in the 24-month follow-up, with reduced revascularization rates. The predictive variables of major cardiac events were as follows: diabetes mellitus, FC III angina, and MLA on intravascular ultrasound.

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Out of Sight, Out of Heart?

Late outcome of sirolimus-eluting stents: comparison of multidetector computed tomography with quantitative coronary angiography and intravascular ultrasound

The use of intravascular ultrasound in deciding on the treatment of moderate coronary lesions

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Electronic Document Format (ABNT)

Electronic Document Format (APA)

Electronic Document Format (ISO)

Electronic Document Format (Vancouver)

Electronic Document Format (ABNT)

Electronic Document Format (APA)

Electronic Document Format (ISO)