ก.ค. 14, 2563 by Philips
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Ostial and bifurcation lesions


Ostial and bifurcation lesions represent nearly 40% of complex PCI’s.1

Clinical image of Ostial and bifurcation lesions

Clinical challenges
 

  • Ostial and bifurcation lesions are associated with higher rates of adverse cardiac events.2,3
  • Angiographic details of ostial and bifurcation lesions are often obscured due to angulation and overlap.
  • Identifying the proper treatment strategy is difficult with traditional angiography.Risk of plaque or carina shift could cut off blood supply

89% reduction in all-cause mortality at 4 years.4

OB graphic

Philips IVUS and SyncVision advanced imaging solution:

 
  •  Study data reported IVUS guidance was associated with an 89% reduction in all-cause mortality in bifurcation lesions and 50% reduction in the compsite of cardiovascular death, MI, or TLR in ostial lesions.2
  • Assist in identifying the true ostium, plaque distribution, vessel sizez and lesion length.
  • Aid in therapy delivery by avoiding geographic miss or extending stent struts into the ostium.Co-registration allows you to more easily coorelate plaque and treatment locations to the angiogram.

Clinical image of AngioSculpt PTCA scoring balloon catheter

AngioSculpt PTCA scoring balloon catheter:

 
  • Helps you apply maximum dilation force with less risk of dissection compared to other PTCA balloons.6
  • Avoids slippage during dilation by locking in place with its unique rectangular nitinol scoring elements.
  • Associated with excellent and safe procedural results, a low rate of crossover to side-branch stenting, and favorable outcomes for the treatment of true bifurcation lesions.

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Resources


1. 
Kedhi E, Joesoef KS, McFadden E, Wassing J, van Mieghem C, Goedhart D, Smits PC. Second-generation everolimus-eluting and paclitaxel-eluting stents in real-life practice (COMPARE): a randomised trial. Lancet. 2010 Jan 16;375(9710):201-9.
2. Patel et al. Impact of intravascular ultrasound on the long-term clinical outcomes in the treatment of coronary ostial lesions. Catheter Cardiovasc Interv 2013 June 1. In press doi: 10.1002/ccd.25034.)
3. Iakovou I, et al. Incidence, predictors, and outcome of thrombosis after successful implantation of drug eluting stents. JAMA 2005;293:2126:2130.
4. Kim, S, Kim Y, et al, Long-Term Outcomes of Intravascular Ultrasound-Guided Stenting in Coronary Bifurcation Lesions, Am J Cardiol 2010;106:612– 618.
5. Mooney M, Teirstein P, Moses J, et al. Final results from the U.S. multi-center trial of the AngioSculpt Scoring Balloon Catheter for the treatment of complex coronary artery lesions. Am J Cardiol. 2006;98 (suppl 8):121M.
6. Weisz G, Metzger DC, Liberman HA, O’Shaughnessy CD, Douglas JS, Turco MA, Mehran R, Gershony G, Leon MB, Moses JW. A provisional strategy for treating true bifurcation lesions employing a scoring balloon for the side branch: Final Results of the AGILITY Trial. Catheterization and Cardiovascular Interventions 2013;82(3):352-359.

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