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Evaluation of coronary plaque and stent deployment by intravascular optical coherence tomography in elderly patients with unstable angina and non-ST-elevation myocardial infarction

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Journal of Geriatric Cardiology 2007年第1期4卷 3-9页

作者： caiyi lu shiwen wang wei yan xingli wu yuxiao zhang qiao xue muyang yan peng liu rui chen jinyue zhai Institute of Geriatric Cardiology Chinese PLA General HospitalBeijing 100853China

Objective To evaluate the feasibility and efficacy of intravascular optical coherence tomography(OCT)in the assessment of plaque characteristics and drug eluting stent deployment quality in the elderly patients with unstable angina(UA)and non-ST segment elevation myocardial infarction(NSTEMI).Methods OCT was used in elderly patients undergoing percutaneous coronary *** patients,9 males and 6 females with mean age of 72.6±5.3 years(range 67-92 years)were enrolled in the *** were obtained before initial balloon dilatation and following stent *** plaque characteristics before dilation,vessel dissection,tissue prolapse,stent apposition and strut distribution after stent implantation were *** Fifteen lesions were selected from 32 angiographic lesions as study lesions for OCT imaging after diagnostic coronary *** were 7 lesions in the left anterior descending artery,5 lesions in the right coronary artery and 3 lesions in the left circumflex coronary *** them,12(80.0%)were lipid-rich plaques,and 10(66.7%)were vulnerable plaques with fibrous cap thickness 54.2±7.3μ*** ruptured culprit plaques(46.7%)were found;4 in UA patients and 3 in NSTEMI *** prolapse was observed in 11 lesions(73.3%).Irregular stent strut distribution was detected in 8 lesions(53.3%).Vessel dissections were found in 5 lesions(33.3%).Incomplete stent apposition was observed in 3 stents(20%)with mean spacing between the struts and the vessel wall 172±96 mm(range 117-436 mm).Conclusions 1)It is safe and feasible to perform intravascular OCT to differentiate vulnerable coronary plaque and monitor stent deployment in elderly patients with UA and USTEMI.2)Coronary plaques in elderly patients with UA and USTEMI could be divided into acute ruptured plaque,vulnerable plaque,lipid-rich plaque,and stable plaque.3)Minor or critical plaque rupture is one of the mechanisms of UA in elderly patients.4)Present drug eluting stent

关键词： optical coherence tomography acute coronary syndrome percutaneous coronary intervention stent elderly

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