Intravascular ultrasound-guided percutaneous coronary intervention for syphilitic coronary ostial lesions: a single-center case series - Summary - MDSpire
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: A retrospective analysis was conducted on patients diagnosed with SCAOL who underwent IVUS-guided PCI.
Method: Intravascular ultrasound was utilized to assess lesion characteristics and guide stent placement.
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. ---
