Type c coronary dissections demonstrated significantly more frequent angiographic regression at 6-month follow-up compared to other dissection types (p<0.001).
Observational (n=64)
Yes
Does a novel angiographic classification system predict regression of coronary dissections after plain old balloon angioplasty?
A novel angiographic classification based on dissection lumen width and outer edge better predicts the regression of coronary dissections after balloon angioplasty compared to standard NHLBI criteria.
Absolute Event Rate: 77.8% vs 16.1%
p-value: p=<0.001
Coronary dissection after plain old balloon angioplasty often shows regression during follow-up. This study sought to determine whether we can predict such phenomenon angiographically. We analyzed 64 patients with 71 type B-D coronary dissections determined by the National, Heart, Lung, and Blood Institute (NHLBI) criteria. Regression was considered present when minimal lumen diameter increased by more than 0.3 mm during follow-up. Dissections were divided into subgroups using the NHLBI criteria and our classification in which type a and b dissections were characterized by the width of a dissection lumen exceeding one quarter of the reference diameter with the outer edge of the dissection lumen within the boundary of reference in type a and beyond it in type b. In type c and type d dissections, the width of the dissection lumen was within one quarter of the reference with its outer edge within the boundary of reference in type c and beyond it in type d. Type e dissection had a protruding flap or spiral appearance. Regression was recognized in 23.9%. The distribution of dissection types was similar in the groups with and without regression by the NHLBI criteria, but type c dissection had regression more frequently than the other types of coronary dissections (p<0.001) using our classification.
Shigeyama et al. (Mon,) conducted a observational in Coronary dissection after plain old balloon angioplasty (n=64). Type c coronary dissection (thin dissection lumen within reference boundary) vs. Other types of coronary dissections (types a, b, d, e) was evaluated on Angiographic regression of coronary dissection (minimal lumen diameter increase >0.3 mm) (p=<0.001). Type c coronary dissections demonstrated significantly more frequent angiographic regression at 6-month follow-up compared to other dissection types (p<0.001).