The Clinical Value Of Interventional Diagnosis In The Intermediate Coronary Artery Stenosis

PART 1:The assessment of significance of intermediate coronary stenosis with intravascular ultrasoundOBJECTIVE:To compared the detection of stenosis by angiography and identified angiographic predictors of severe luminal stenosis on intravascular ultrasound (IVUS)in patients with intermediate coronary stenosis. METHODS:150 patients with coronary intermediate stenosis by quantitative coronary angiography (QCA) and underwent IVUS assessment of the lesions artery. The results from IVUS and QCA were compared using unpaired t-test. Multiple regression analysis was performed to identify parameters that could predict the presence of severe stenosis on IVUS. RESULTS:A total of 280 stenotic coronary lesions were classified as intermediate by QCA. There was a right correlation between IVUS and QCA with respect to percentage of stenosis, minimum luminal diameter, reference segment diameter. In contrast, there was a difference in the assessment luminal diameter stenosis with minimum luminal area. The stenosis detected by IVUS could find the severity of stenosis, could reduce much MACE relatively.CONCLUSIONS:In patients with angiographically intermediate lesions, the frequency of severe stenosis detected by IVUS was high, indicating that angiography underestimated the severity of stenosis. Smoking and Hypertension could be used to stratify these lesions into groups with higher risk of MACE. PART 2:The ability of optical coherence tomography for assessment of intermediate coronary stenosis comparison with quantitative coronary angiographyOBJECTIVE:Optical coherence tomography is a new intravasc ular imaging method with a high resolution of approximately 10μm.This study aims; to examine quantitative optical coherence tomography (OCT) derived measurements intermediate coronary stenosis from quantitative coronary angiography(QCA)METHODS:120 patients with coronary intermediate stenosis by quantitative coronary angiography (QCA) and underwent OCT assessment of the lesions artery. The results from QCA and OCT were compared using unpaired t-test. Multiple regression analysis was performed. The latter of MACE was significantly lower than that by QCA detected.RESULTS:A total of 67 stenotic coronary lesions were classified as intermediate by QCA. Subgroup of the plaque was analyzed, OCT could estimate the fibrous cap thickness,and it was 94±24.7(μm), the reference segment diameter was 3.06±0.12 (mm), the minimum luminal diameter was 1.84±0.13 (mm). At 12 months of clinical follow-up,4 patients was found to have MACE.it was much lower than QCA group. CONCLUSIONS:In patients with angiographically intermediate lesions, the frequency of severe stenosis detected by OCT was high, indicating that angiograp-hy underestimated the severity of stenosis. This unique resolution of OCT suggests that it maybe well suited for identifying vulnerable plaques in patients at risk. Optical coherence tomography is a feasible imaging modality in patients and allows us to identify quantitative plaque characters, such as fibrous cap, Vulnerable plaque.