Zusammenfassung
Wir berichten den Verlauf eines Patienten nach ‘Crush-Stenting’ von Paclitaxel-freisetzenden TAXUS-Stents innerhalb einer LAD/D1-Bifurkationsstenose. Speziell zur Evaluation der neointimalen Antwort des Hauptgefäßes auf diesen Eingriff führten wir nach 9 Monaten eine elektive Re-Angiographie mit intravaskulärer Bildgebung mittels ‘Optical Coherence Tomography (OCT)’, einer neuartigen hochauflösenden Bildgebungstechnik, und IVUS durch. Die Untersuchung zeigte, das die Stents im Hauptgefäß mit einer homogenen neointimalen Schicht überdeckt waren ohne Hinweise auf eine bedeutsame Lumeneinengung oder eine Malapposition. Im Vergleich zu IVUS bestätigte OCT die Einbettung der Stentstreben in die Gefäßwand mit einer deutlich überlegenen Darstellungsqualität und ermöglichte darüber hinaus neue Einsichten in das Stentverhalten innerhalb offener Bifurkationsstellen.
Summary
We report a case of crush-stenting with Paclitaxeleluting TAXUS stents in a left anterior descending artery (LAD) bifurcation lesion. In order to obtain precise information on the mid-term neointimal response of the main vessel to this approach, we evaluated the patient angiographically 9 months later, including intravascular visualization with optical coherence tomography (OCT), a new high resolution imaging technique, and IVUS. The evaluation revealed that there was a homogeneous neointimal coverage of the main vessel stents without evidence of significant recurrent lumen renarrowing or malappositions. Compared to IVUS, OCT proved the coverage of the stent struts adjacent to the vessel wall with a superior imaging quality and, in addition, provided new insights into the stent performance at the open bifurcation site.
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Buellesfeld, L., Lim, V., Gerckens, U. et al. Comparative endoluminal visualization of TAXUS crush-stenting at 9 months follow-up by intravascular ultrasound and optical coherence tomography. ZS Kardiologie 94, 690–694 (2005). https://doi.org/10.1007/s00392-005-0276-4
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DOI: https://doi.org/10.1007/s00392-005-0276-4