Favorable strategy for the ostial lesion of the left anterior descending coronary artery

Influence on narrowing of circumflex coronary artery

Yasushi Asakaura, Shunsuke Takagi, Shiro Ishikawa, Keiko Asakura, Koichiro Sueyoshi, Munehisa Sakamoto, Seiji Takatsuki, Takahiro Oda, Masahiro Nakagawa, Yoshiko Furukawa, Kazuhiro Oyamada, Shiro Iwanaga, Satoshi Ogawa, Tomoaki Hinohara

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

We examined the effectiveness of Palmaz-Schatz (P-S) stent and directional coronary atherectomy (DCA) in ostial lesions of left anterior descending arteries (LAD). The P-S stent was implanted in 11 cases at LAD ostial lesions, and DCA was performed in 13 cases. Percent stenosis and vessel diameter at the target site and the ostium of the circumflex coronary artery (LCX) were measured before and after the procedure. The initial success rate was 100% in both groups. NO major complication occurred. LAD ostial lesions were improved from 81.3 ± 3.4% to -8.1 ± 5.7% by P-S stent and from 82.8 ± 2.6% to -2.7 ± 3.9% by DCA. LCX ostial vessel diameter was not changed by DCA (from 3.0 ± 0.2 mm to 3.1 ± 0.3 mm); however, it was significantly decreased by P-S stent (from 2.9 ± 0.2 mm to 2.6 ± 0.2 mm, P < 0.01). When the angle of LAD and LCX was ≤80°from the view of RAO 30°and Caudal 30°, the LCX ostium was significantly narrowed by stenting at LAD ostium (P < 0.01). These findings indicate that both the P-S stent and DCA are effective and safe therapies for LAD ostial lesions in cases with LAD- LCX angle >80°. In cases with LAD-LCX angle ≤80°, however, DCA is a favored therapy rather than P-S stenting to avoid narrowing of the LCX ostium.

Original languageEnglish
Pages (from-to)95-104
Number of pages10
JournalCatheterization and Cardiovascular Diagnosis
Volume43
Issue number1
DOIs
Publication statusPublished - 1998 Jan

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Coronary Atherectomy
Coronary Vessels
Stents
Arteries
Pathologic Constriction

Keywords

  • Directional coronary atherectomy
  • Left anterior descending artery
  • Ostial lesion
  • Palmaz-Schatz stenting

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Favorable strategy for the ostial lesion of the left anterior descending coronary artery : Influence on narrowing of circumflex coronary artery. / Asakaura, Yasushi; Takagi, Shunsuke; Ishikawa, Shiro; Asakura, Keiko; Sueyoshi, Koichiro; Sakamoto, Munehisa; Takatsuki, Seiji; Oda, Takahiro; Nakagawa, Masahiro; Furukawa, Yoshiko; Oyamada, Kazuhiro; Iwanaga, Shiro; Ogawa, Satoshi; Hinohara, Tomoaki.

In: Catheterization and Cardiovascular Diagnosis, Vol. 43, No. 1, 01.1998, p. 95-104.

Research output: Contribution to journalArticle

Asakaura, Y, Takagi, S, Ishikawa, S, Asakura, K, Sueyoshi, K, Sakamoto, M, Takatsuki, S, Oda, T, Nakagawa, M, Furukawa, Y, Oyamada, K, Iwanaga, S, Ogawa, S & Hinohara, T 1998, 'Favorable strategy for the ostial lesion of the left anterior descending coronary artery: Influence on narrowing of circumflex coronary artery', Catheterization and Cardiovascular Diagnosis, vol. 43, no. 1, pp. 95-104. https://doi.org/10.1002/(SICI)1097-0304(199801)43:1<95::AID-CCD28>3.0.CO;2-R
Asakaura, Yasushi ; Takagi, Shunsuke ; Ishikawa, Shiro ; Asakura, Keiko ; Sueyoshi, Koichiro ; Sakamoto, Munehisa ; Takatsuki, Seiji ; Oda, Takahiro ; Nakagawa, Masahiro ; Furukawa, Yoshiko ; Oyamada, Kazuhiro ; Iwanaga, Shiro ; Ogawa, Satoshi ; Hinohara, Tomoaki. / Favorable strategy for the ostial lesion of the left anterior descending coronary artery : Influence on narrowing of circumflex coronary artery. In: Catheterization and Cardiovascular Diagnosis. 1998 ; Vol. 43, No. 1. pp. 95-104.
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abstract = "We examined the effectiveness of Palmaz-Schatz (P-S) stent and directional coronary atherectomy (DCA) in ostial lesions of left anterior descending arteries (LAD). The P-S stent was implanted in 11 cases at LAD ostial lesions, and DCA was performed in 13 cases. Percent stenosis and vessel diameter at the target site and the ostium of the circumflex coronary artery (LCX) were measured before and after the procedure. The initial success rate was 100{\%} in both groups. NO major complication occurred. LAD ostial lesions were improved from 81.3 ± 3.4{\%} to -8.1 ± 5.7{\%} by P-S stent and from 82.8 ± 2.6{\%} to -2.7 ± 3.9{\%} by DCA. LCX ostial vessel diameter was not changed by DCA (from 3.0 ± 0.2 mm to 3.1 ± 0.3 mm); however, it was significantly decreased by P-S stent (from 2.9 ± 0.2 mm to 2.6 ± 0.2 mm, P < 0.01). When the angle of LAD and LCX was ≤80°from the view of RAO 30°and Caudal 30°, the LCX ostium was significantly narrowed by stenting at LAD ostium (P < 0.01). These findings indicate that both the P-S stent and DCA are effective and safe therapies for LAD ostial lesions in cases with LAD- LCX angle >80°. In cases with LAD-LCX angle ≤80°, however, DCA is a favored therapy rather than P-S stenting to avoid narrowing of the LCX ostium.",
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AU - Sueyoshi, Koichiro

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AU - Furukawa, Yoshiko

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