Incidence, predictors, and outcomes of distal vessel expansion on follow-up intravascular ultrasound after recanalization of chronic total occlusions using new-generation drug-eluting stents: Data from the CTO-IVUS randomized trial

Sung Jin Hong; Byeong Keuk Kim; Young Joo Kim; Seung Woon Rha; Seung Jin Lee; Hee Yeol Kim; Jin Ho Choi; Chul Min Ahn; Jung Sun Kim; Young Guk Ko; Doonghoon Choi; Myeong Ki Hong; Yangsoo Jang

doi:10.1002/ccd.28461

Incidence, predictors, and outcomes of distal vessel expansion on follow-up intravascular ultrasound after recanalization of chronic total occlusions using new-generation drug-eluting stents: Data from the CTO-IVUS randomized trial

Sung Jin Hong, Byeong Keuk Kim, Young Joo Kim, Seung Woon Rha, Seung Jin Lee, Hee Yeol Kim, Jin Ho Choi, Chul Min Ahn, Jung Sun Kim, Young Guk Ko, Doonghoon Choi, Myeong Ki Hong, Yangsoo Jang

Department of Biomedical Sciences

Research output: Contribution to journal › Article › peer-review

3 Citations (Scopus)

Abstract

Objectives: To evaluate the incidence, predictors, and outcomes of distal vessel expansion on intravascular ultrasound (IVUS) after recanalization of chronic total occlusion (CTO) particularly using new-generation drug-eluting stent (DES). Background: The luminal changes of narrowed vessels distal to CTO segments after recanalization using new-generation DES have rarely been studied. Methods: This substudy of the CTO-IVUS (Chronic Total Occlusion InterVention with drUg-eluting Stents) trial included a total of 69 new-generation DES-treated CTOs with serial matched IVUS analyses at index percutaneous coronary intervention (PCI) and at 1-year follow-up. The predictors of distal vessel expansion, any increase of lumen area at the distal reference (LA_distal) on 1-year follow-up IVUS, were evaluated by multivariable binary logistic analyses. Results: Distal vessel expansion was identified in 46 (67%). Independent determinants of distal vessel expansion were proximal CTO, a smaller LA_distal at the index PCI, a greater minimal stent area-to-LA_distal (MSA-to-LA_distal) ratio, and a greater lumen area at the distal stent edge-to-LA_distal (LA_edge-to-LA_distal) ratio. The cut-off values of a MSA-to-LA_distal ratio and a LA_edge-to-LA_distal ratio predicting the distal vessel expansion by receiver operating characteristic curve analysis were 1.0 and 1.1, respectively. During the median 5.1 years, rates of target vessel revascularization, cardiac death, and stent thrombosis were similar in the distal vessel-expanded and nonexpanded groups. Conclusion: After opening CTO with new-generation DES, two-thirds of patients exhibited distal vessel expansion on 1-year follow-up IVUS. Expansion determinants were a proximal CTO, lower LA_distal, and larger stent areas relative to the LA_distal (modifiable procedural predictors).

Original language	English
Pages (from-to)	154-164
Number of pages	11
Journal	Catheterization and Cardiovascular Interventions
Volume	95
Issue number	1
DOIs	https://doi.org/10.1002/ccd.28461
Publication status	Published - 2020 Jan 1

Bibliographical note

Publisher Copyright:
© 2019 Wiley Periodicals, Inc.

Keywords

chronic coronary total occlusion
drug-eluting stent
intravascular ultrasound

ASJC Scopus subject areas

Radiology Nuclear Medicine and imaging
Cardiology and Cardiovascular Medicine

Access to Document

10.1002/ccd.28461

Fingerprint

Dive into the research topics of 'Incidence, predictors, and outcomes of distal vessel expansion on follow-up intravascular ultrasound after recanalization of chronic total occlusions using new-generation drug-eluting stents: Data from the CTO-IVUS randomized trial'. Together they form a unique fingerprint.

Cite this

Hong, S. J., Kim, B. K., Kim, Y. J., Rha, S. W., Lee, S. J., Kim, H. Y., Choi, J. H., Ahn, C. M., Kim, J. S., Ko, Y. G., Choi, D., Hong, M. K., & Jang, Y. (2020). Incidence, predictors, and outcomes of distal vessel expansion on follow-up intravascular ultrasound after recanalization of chronic total occlusions using new-generation drug-eluting stents: Data from the CTO-IVUS randomized trial. Catheterization and Cardiovascular Interventions, 95(1), 154-164. https://doi.org/10.1002/ccd.28461

Incidence, predictors, and outcomes of distal vessel expansion on follow-up intravascular ultrasound after recanalization of chronic total occlusions using new-generation drug-eluting stents: Data from the CTO-IVUS randomized trial. / Hong, Sung Jin; Kim, Byeong Keuk; Kim, Young Joo et al.
In: Catheterization and Cardiovascular Interventions, Vol. 95, No. 1, 01.01.2020, p. 154-164.

Research output: Contribution to journal › Article › peer-review

Hong, SJ, Kim, BK, Kim, YJ, Rha, SW, Lee, SJ, Kim, HY, Choi, JH, Ahn, CM, Kim, JS, Ko, YG, Choi, D, Hong, MK & Jang, Y 2020, 'Incidence, predictors, and outcomes of distal vessel expansion on follow-up intravascular ultrasound after recanalization of chronic total occlusions using new-generation drug-eluting stents: Data from the CTO-IVUS randomized trial', Catheterization and Cardiovascular Interventions, vol. 95, no. 1, pp. 154-164. https://doi.org/10.1002/ccd.28461

Hong SJ, Kim BK, Kim YJ, Rha SW, Lee SJ, Kim HY et al. Incidence, predictors, and outcomes of distal vessel expansion on follow-up intravascular ultrasound after recanalization of chronic total occlusions using new-generation drug-eluting stents: Data from the CTO-IVUS randomized trial. Catheterization and Cardiovascular Interventions. 2020 Jan 1;95(1):154-164. doi: 10.1002/ccd.28461

Hong, Sung Jin ; Kim, Byeong Keuk ; Kim, Young Joo et al. / Incidence, predictors, and outcomes of distal vessel expansion on follow-up intravascular ultrasound after recanalization of chronic total occlusions using new-generation drug-eluting stents : Data from the CTO-IVUS randomized trial. In: Catheterization and Cardiovascular Interventions. 2020 ; Vol. 95, No. 1. pp. 154-164.

@article{e9cd0577e3e04b698b85f93b681fafbf,

title = "Incidence, predictors, and outcomes of distal vessel expansion on follow-up intravascular ultrasound after recanalization of chronic total occlusions using new-generation drug-eluting stents: Data from the CTO-IVUS randomized trial",

abstract = "Objectives: To evaluate the incidence, predictors, and outcomes of distal vessel expansion on intravascular ultrasound (IVUS) after recanalization of chronic total occlusion (CTO) particularly using new-generation drug-eluting stent (DES). Background: The luminal changes of narrowed vessels distal to CTO segments after recanalization using new-generation DES have rarely been studied. Methods: This substudy of the CTO-IVUS (Chronic Total Occlusion InterVention with drUg-eluting Stents) trial included a total of 69 new-generation DES-treated CTOs with serial matched IVUS analyses at index percutaneous coronary intervention (PCI) and at 1-year follow-up. The predictors of distal vessel expansion, any increase of lumen area at the distal reference (LAdistal) on 1-year follow-up IVUS, were evaluated by multivariable binary logistic analyses. Results: Distal vessel expansion was identified in 46 (67%). Independent determinants of distal vessel expansion were proximal CTO, a smaller LAdistal at the index PCI, a greater minimal stent area-to-LAdistal (MSA-to-LAdistal) ratio, and a greater lumen area at the distal stent edge-to-LAdistal (LAedge-to-LAdistal) ratio. The cut-off values of a MSA-to-LAdistal ratio and a LAedge-to-LAdistal ratio predicting the distal vessel expansion by receiver operating characteristic curve analysis were 1.0 and 1.1, respectively. During the median 5.1 years, rates of target vessel revascularization, cardiac death, and stent thrombosis were similar in the distal vessel-expanded and nonexpanded groups. Conclusion: After opening CTO with new-generation DES, two-thirds of patients exhibited distal vessel expansion on 1-year follow-up IVUS. Expansion determinants were a proximal CTO, lower LAdistal, and larger stent areas relative to the LAdistal (modifiable procedural predictors).",

keywords = "chronic coronary total occlusion, drug-eluting stent, intravascular ultrasound",

author = "Hong, {Sung Jin} and Kim, {Byeong Keuk} and Kim, {Young Joo} and Rha, {Seung Woon} and Lee, {Seung Jin} and Kim, {Hee Yeol} and Choi, {Jin Ho} and Ahn, {Chul Min} and Kim, {Jung Sun} and Ko, {Young Guk} and Doonghoon Choi and Hong, {Myeong Ki} and Yangsoo Jang",

note = "Publisher Copyright: {\textcopyright} 2019 Wiley Periodicals, Inc.",

year = "2020",

month = jan,

day = "1",

doi = "10.1002/ccd.28461",

language = "English",

volume = "95",

pages = "154--164",

journal = "Catheterization and Cardiovascular Interventions",

issn = "1522-1946",

publisher = "Wiley-Liss Inc.",

number = "1",

}

TY - JOUR

T1 - Incidence, predictors, and outcomes of distal vessel expansion on follow-up intravascular ultrasound after recanalization of chronic total occlusions using new-generation drug-eluting stents

T2 - Data from the CTO-IVUS randomized trial

AU - Hong, Sung Jin

AU - Kim, Byeong Keuk

AU - Kim, Young Joo

AU - Rha, Seung Woon

AU - Lee, Seung Jin

AU - Kim, Hee Yeol

AU - Choi, Jin Ho

AU - Ahn, Chul Min

AU - Kim, Jung Sun

AU - Ko, Young Guk

AU - Choi, Doonghoon

AU - Hong, Myeong Ki

AU - Jang, Yangsoo

PY - 2020/1/1

Y1 - 2020/1/1

N2 - Objectives: To evaluate the incidence, predictors, and outcomes of distal vessel expansion on intravascular ultrasound (IVUS) after recanalization of chronic total occlusion (CTO) particularly using new-generation drug-eluting stent (DES). Background: The luminal changes of narrowed vessels distal to CTO segments after recanalization using new-generation DES have rarely been studied. Methods: This substudy of the CTO-IVUS (Chronic Total Occlusion InterVention with drUg-eluting Stents) trial included a total of 69 new-generation DES-treated CTOs with serial matched IVUS analyses at index percutaneous coronary intervention (PCI) and at 1-year follow-up. The predictors of distal vessel expansion, any increase of lumen area at the distal reference (LAdistal) on 1-year follow-up IVUS, were evaluated by multivariable binary logistic analyses. Results: Distal vessel expansion was identified in 46 (67%). Independent determinants of distal vessel expansion were proximal CTO, a smaller LAdistal at the index PCI, a greater minimal stent area-to-LAdistal (MSA-to-LAdistal) ratio, and a greater lumen area at the distal stent edge-to-LAdistal (LAedge-to-LAdistal) ratio. The cut-off values of a MSA-to-LAdistal ratio and a LAedge-to-LAdistal ratio predicting the distal vessel expansion by receiver operating characteristic curve analysis were 1.0 and 1.1, respectively. During the median 5.1 years, rates of target vessel revascularization, cardiac death, and stent thrombosis were similar in the distal vessel-expanded and nonexpanded groups. Conclusion: After opening CTO with new-generation DES, two-thirds of patients exhibited distal vessel expansion on 1-year follow-up IVUS. Expansion determinants were a proximal CTO, lower LAdistal, and larger stent areas relative to the LAdistal (modifiable procedural predictors).

AB - Objectives: To evaluate the incidence, predictors, and outcomes of distal vessel expansion on intravascular ultrasound (IVUS) after recanalization of chronic total occlusion (CTO) particularly using new-generation drug-eluting stent (DES). Background: The luminal changes of narrowed vessels distal to CTO segments after recanalization using new-generation DES have rarely been studied. Methods: This substudy of the CTO-IVUS (Chronic Total Occlusion InterVention with drUg-eluting Stents) trial included a total of 69 new-generation DES-treated CTOs with serial matched IVUS analyses at index percutaneous coronary intervention (PCI) and at 1-year follow-up. The predictors of distal vessel expansion, any increase of lumen area at the distal reference (LAdistal) on 1-year follow-up IVUS, were evaluated by multivariable binary logistic analyses. Results: Distal vessel expansion was identified in 46 (67%). Independent determinants of distal vessel expansion were proximal CTO, a smaller LAdistal at the index PCI, a greater minimal stent area-to-LAdistal (MSA-to-LAdistal) ratio, and a greater lumen area at the distal stent edge-to-LAdistal (LAedge-to-LAdistal) ratio. The cut-off values of a MSA-to-LAdistal ratio and a LAedge-to-LAdistal ratio predicting the distal vessel expansion by receiver operating characteristic curve analysis were 1.0 and 1.1, respectively. During the median 5.1 years, rates of target vessel revascularization, cardiac death, and stent thrombosis were similar in the distal vessel-expanded and nonexpanded groups. Conclusion: After opening CTO with new-generation DES, two-thirds of patients exhibited distal vessel expansion on 1-year follow-up IVUS. Expansion determinants were a proximal CTO, lower LAdistal, and larger stent areas relative to the LAdistal (modifiable procedural predictors).

KW - chronic coronary total occlusion

KW - drug-eluting stent

KW - intravascular ultrasound

UR - http://www.scopus.com/inward/record.url?scp=85071296502&partnerID=8YFLogxK

U2 - 10.1002/ccd.28461

DO - 10.1002/ccd.28461

M3 - Article

C2 - 31460693

AN - SCOPUS:85071296502

SN - 1522-1946

VL - 95

SP - 154

EP - 164

JO - Catheterization and Cardiovascular Interventions

JF - Catheterization and Cardiovascular Interventions

IS - 1

ER -

Incidence, predictors, and outcomes of distal vessel expansion on follow-up intravascular ultrasound after recanalization of chronic total occlusions using new-generation drug-eluting stents: Data from the CTO-IVUS randomized trial

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Cite this