Intravascular ultrasound-guided percutaneous coronary intervention for syphilitic coronary ostial lesions: a single-center case series - Summary - MDSpire
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Percutaneous Coronary Intervention Guided by Intravascular Ultrasound for Coronary Ostial Lesions Due to Syphilis: A Case Series from a Single Center
To preliminarily explore the feasibility and safety of IVUS-guided PCI for syphilitic coronary artery ostial lesions (SCAOL) and provide insights for optimal stenting strategies.
Approach:
Method: label
Method: text
Key Findings:
All seven patients successfully received second-generation drug-eluting stents.
Pre-procedural IVUS showed concentric fibrous hyperplasia and significant negative remodeling.
Six patients remained free of major adverse cardiovascular events (MACE) over a median follow-up of 4 years.
One patient developed NSTEMI due to severe in-stent restenosis after receiving a stent with minimal protrusion.
Interpretation:
IVUS-guided PCI was technically feasible for patients with SCAOL, suggesting that moderate aortic protrusion may help ensure ostial coverage.
Limitations:
Small sample size limits generalizability.
Retrospective design may introduce bias.
Conclusion:
Further multicenter studies are needed to confirm optimal stent positioning strategies and the impact of protrusion length on restenosis.
In a multicenter registry study, genetic diagnoses were associated with substantially lower cognitive, language, and motor scores; while birth weight, surgical timing, hospitalization burden, and caregiver education were also associated with outcomes.
