- Email: [email protected]
Multi-modality Imaging for Stent Edge Assessment
APRIL 23e26, 2013
Invasive Coronary Imaging: IVUS, OCT, Spectroscopy, and Other Thursday, April 25, 2013 8:30 AM w 12:30 PM (Abstract nos. AS-168, AS-169, AS-170, AS-171, AS-172, AS-173, AS-174, AS-175) - AS-168 Clinical and Angiographic Features of Coronary Ostial Lesion with a Damping of the Pressure Tracing. Soe Hee Ann, Jun Ho Lee, Jong Min Kim, Shin-Jae Kim, Eun-Seok Shin. Ulsan University Hospital, Ulsan, Korea (Republic of). Background: When performing coronary angiography, diagnostic catheter intubation of the ostium often leads to a damping of the pressure tracing. Although catheter induced coronary spasm is suggested as the main mechanism of damping, atherosclerotic ostial lesion may be the one of the differential diagnoses. The purpose of this retrospective study is to find out the risk factors of ostial lesion in patients showing pressure damping during coronary angiography. Methods: Among 2,926 consecutive patients who underwent diagnostic coronary angiography from September 2010 to March 2012 in a single center, 76 ostium in 67 patients (incidence, 2.2%) were recorded as a damping of the pressure tracing. Pressure damping was defined as abrupt decrease of the coronary blood pressure with blunted pulse pressure after the engagement of diagnostic catheter. We divided 2 groups with atherosclerotic ostial lesion (n¼31) and ostial non-lesion (n¼45) using angiography and intravascular ultrasound (IVUS). We compared the clinical and angiographic characterisitics between the 2 groups and analysed using IVUS Virtual Histology (IVUS-VH). Results: Ostial lesion group showed more frequent familial history of cardiovascular disease and pressure damping of left main ostium than ostial non-lesion group. Percutaneous coronary intervention (PCI) on damped ostium was performed more frequently in ostial lesion group than ostial non-lesion group (n¼20 (64.5%) vs. n¼14 (31.1%), p¼0.004). PCI on damped ostium had more frequent another atherosclerotic lesion (diameter stenosis > 50%, n¼14 (35.0%)) than non-PCI group (n¼0). In IVUS, ostial lesion group showed prominent plaque burden and IVUSVH showed that fibrous tissue was more dominant plaque component in ostial lesion group than ostial non-lesion group. Table Gray scale, VH-IVUS findings Variables F volume/plaque (%) FF volume/plaque (%) NC volume/plaque (%) DC volume/plaque (%)
Ostial Lesion (Left. n¼ 11)
Ostial Lesion (Right, n¼13)
P- value
66.58.8 12.95.9 15.07.9 5.74.2
65.511.1 16.69 1 12.38.8 5.68.2
0.81 0.25 0.45 0.98
Conclusion: During the coronary angiography, ostial pressure damping is not rare. When we meet another atherosclerotic lesion other
than pressure damped ostium, the ostium might be significant atherosclerotic lesion. So more detailed coronary evaluation like IVUS is needed in a patient of pressure damped ostium with another site of atherosclerotic lesion.
- AS-169 Clinical, Angiographic, and Intravascular Ultrasound Predictors of Early Stent Thrombosis in Patients with Acute Myocardial Infarction. Young Joon Hong, Myung Ho Jeong, Yun Ha Choi, Soo Young Park, Hae Chang Jeong, Jae Yeong Cho, Soo Young Jang, Sang Cheol Cho, Jong Hyun Yoo, Keun Ho Park, Doo Sun Sim, Ju Han Kim, Youngkeun Ahn, Jeong Gwan Cho, Jong Chun Park, Jung Chaee Kang. Chonnam National University Hospital, Gwangju, Korea (Republic of). Background: The clinical, angiographic, and intravascular ultrasound predictors of early stent thrombosis (EST including acute and subacute ST) in acute myocardial infarction (AMI) patients are still not well known. The purpose of this study was to find out predictors of EST in patients with 418 AMI patients (155 ST segment elevation and 263 nonST segment elevation MI). Methods: All patients received 300 mg (for non-ST segment elevation MI) or 600 mg (ST segment elevation MI) of clopidogrel loading at emergency department and dual antiplatelet therapy was used in all patients at least 1 month after stent implantation (260 drug-eluting stents and 158 bare-metal stents). Results: EST occurred in 16 patients (3.8%). Pre-intervention peak cardiac specific troponin-I (cTnI) was significantly higher (4070 ng/mL vs. 1135 ng/mL, p¼0.002), and plaque rupture (62.5% vs. 34.1%, p¼0.020), thrombi (62.5% vs. 24.4%, p¼0.001), and post-stenting tissue prolapse (68.8% vs. 32.6%, p¼0.003) were observed more frequently in EST group than non-EST group. No-reflow during or after percutaneous coronary intervention was developed more frequently in EST group than non-EST group (87.5% vs. 12.2%, p<0.001). Multivariate analysis showed that no-reflow [odds ratio (OR)¼36.311; 95% confidence interval (CI) 7.218-182.677, p<0.001], pre-intervention peak cTnI (OR¼1.012; 95% CI 1.003-1.021, p¼0.009), and tissue prolapse (OR¼3.203; 95% CI 1.156-8.801, p¼0.029) were the independent predictors of EST. Conclusion: The incidence of EST after stenting of infarct-related arteries was 3.8%. No-reflow, pre-PCI peak cTnI and tissue prolapse were associated with the development of EST after stent implantation in patients with AMI.
- AS-170 Multi-modality Imaging for Stent Edge Assessment. Soe Hee Ann, Jun Ho Lee, Jong Min Kim, Shin-Jae Kim, Eun-Seok Shin. Ulsan University Hospital, Ulsan, Korea (Republic of). Background: Optical coherence tomography (OCT) has a high resolution of approximately 10 mm allowing superior assessment of dissection at the stent edge. The aims of the present study were 1) to evaluate the frequency of edge dissection after stenting by optical coherence tomography (OCT), 2) to compare the incidence of stent edge dissection between angiogram, intravascular ultrasound (IVUS) and OCT, 3) to evaluate plaque composition using IVUS Virtual Histology (IVUS-VH) at the site of stent edge dissections detected by OCT after percutaneous coronary intervention (PCI). Methods: Thirty six consecutive patients (36 lesions: 57 stent edges) who underwent balloon-expandable stent implantation and post stent assessment with OCT and IVUS-VH were included. Results: OCT identified stent ED in 33.3% (19 of 57) of stent edges after PCI with a balloon-expandable stent. Compared with OCT, edge dissections were detected in only 1.8% (1 of 57) of stent edges using angiography and 5.3% (3 of 57) of stent edges using IVUS. Absolute dense calcium, and
The American Journal of Cardiologyâ APRIL 23e26, 2013 ANGIOPLASTY SUMMIT ABSTRACTS/Poster
83B
P O S T E R A B S T R A C T S
APRIL 23e26, 2013 percent necrotic core (22.87.7% vs. 15.411.1%, p¼0.01) and dense calcium volume (3.42.5 mm3 vs. 1.72.8 mm3, p¼0.03) were greater in the ED group than in the non-ED group by IVUS-VH. One patient had implantation of an additional stent to treat the ED during the index PCI.
Angiography Edge dissection Edge dissection IVUS Edge dissection Edge dissection
Edge Dissection by OCT (n¼19)
Non-Edge Dissection by OCT (n¼38)
(+) (-)
1 (1.8%) 18
2 36
(+) (-)
3 (5.3%) 16
0 38
Conclusion: OCT is superior to conventional coronary angiography and IVUS in the identification of stent ED. The risk of ED may be reduced if underlying plaque composition is considered when assessing stent length thereby ensuring that stent landing zones are free of calcium and necrotic core.
- AS-171 Efficacy of Using Non Slip Element Balloon (Lacrosse NSE) to Treatment for In-stent Restenosis Lesion. Optical Coherence Tomography Analysis. Nobuyuki Miyai, Keisuke Oota, Reo Nakamura, Takayoshi Sawanishi, Noriyuki Kinoshita, Katsushige Matsumoto. Kouseikai Takeda Hospital, Kyoto, Japan.
P O S T E R A B S T R A C T S
Background: Drug-eluting stents (DES) have been shown to reduce restenosis rates. However, restenosis after DES implantation is still observed. In this study, we evaluated the efficacy of non slip element balloon (NSE) for target lesion revascularization (TLR) of in-stent restenosis (ISR). Methods: We enrolled 71 patients who underwent TLR for ISR using NSE. We succeeded in performing angiographic follow-up in 58 patients. We classified these patients into a re-restenosis group and a non re-restenosis group. We compared OCT images of pre-procedure with images of post-procedure. Results: Recurrent restenosis was angiographically documented in 18 patients (31%), and TLR was in 17patients (29%). There were no difference in gender, age, and coronary risk factor between a re-restenosis group and a non re-restenosis group. QCA data before and after procedure were not difference between two groups. Tissue coverage structures in stent, for example homogeneous, heterogeneous, and layered, were not difference between two groups. However, peri-stent low signal area had a tendency to be more detected in re-restenosis group compared with non re-restenosis group (73% vs. 32%, p¼0.072). After NSE angioplasty, we detected fissures in 73% of patients. Irregular lumen shape had tendency to be more detected in re-resteosis group (55% vs. 16%, p¼0.069). Stent area change after using NSE was bigger in non re-restenosis group than re-restenosis group (1.67◇ 0.66mm2 vs. 0.52◇ 0.38mm2, p¼0.0039). Conclusion: A treatment with NSE for ISR lesion may be more effective compared with plain old balloon angioplasty.
- AS-172 Clinical Profile of Spontaneous Coronary Dissection in a Community Hospital. Mathew Ravi Cherian, Balasubramaniyan Amirtha Ganesh, Palamalai Arun Prasath. Mahatma Gandhi Medical College and Research Institute, Puducherry, India.
84B
Background: Spontaneous Coronary Artery Dissection (SCAD) is a rare, infrequent cause of Acute Coronary Syndrome which has been reported frequently in young female with free of atheromatous risk factors. Recent reports highlights the varying trend in the incidence of SCAD different from which was predicted. Methods: A total of 300 patients were analysed over a period of 1 year out of which 10 patients had Spontaneous Coronary Artery Dissection (SCAD) who presented to us with Acute Coronary Syndrome (ACS). Presence of SCAD was confirmed by different orthogonal views during Coronary Angiogram which is usually seen as longitudinal ill filling defects. 70% of the cases were non flow limiting lesions which were medically managed and other 30% cases under went Revascularization. Results: The mean age of presentation was 55 years of which all were males. All the patients were smokers and diabetic, with 4% having Hypertension grade II. 70% (7) of the patients presented with Myocardial Infarction, 30% (3) Unstable Angina. Out of 70% of cases of Myocardial Infarction 57% (4) had Anterior Wall Myocardial Infarction of which 75% (3) had involvement of the Left Anterior Descending Artery Territory and 25% (1) had involvement of the Right Coronary Artery. 43% (3) of the cases had Inferior Wall Myocardial Infarction out of which 33% (1) had involvement of Right Coronary Artery and 67% (2) had Left Anterior Descending artery involvement. 43% (3) of SCAD was seen in non culprit arteries. The mean follow up was for 1 year and all the patients are doing well. Conclusion: SCAD is a rare disease which usually involves the young women, but ours were all middle aged males. Left Anterior Coronary artery dissection is the most common location. SCAD can be seen in non culprit arteries also which are incidentally detected during Coronary Angiogram needing revascularization. Intravascular Ultrasonography is an extremely useful tool to evaluate SCAD, which was not done in our setup for economical reasons. This study emphasis the varying clinical profile of SCAD and its prompt identification.
- AS-173 Clinical Profile of Coronary Slow Flow Phenomenon. Mathew Ravi Cherian, Palamalai Arun Prasath, Balasubramaniyan Amirtha Ganesh. Mahatma Gandhi Medical College and Research Institute, Puducherry, India. Background: Coronary slow flow phenomenon (CSFP) is characterized by delayed progression of the contrast medium injected through the coronary tree during Coronary Angiogram (CAG). CSFP is usually observed in patient with various spectrum of Coronary Artery Disease including Acute Coronary Syndrome and Chronic Stable Angina (CSA). The exact pathogenesis of CSFP is unknown, but 80% of patients experience recurrent episodes of typical anginal pain which results in impairment of quality of the life. Methods: We analysed a total of 20 patients over a period of 6 months with Non Obstructive coronaries below the age group of 60 yrs who presented with Ischemic Heart Disease. Coronary Slow Flow was identified using thrombolysis in myocardial infarction frame count (TFC) method introduced by Gibson. Risk factors and profiles of all the patients were studied in detail. Those patients who had Coronary Artery ectasia and coronary aneurysm were excluded. Results: Out of 20 patients presented with CSFP 95% were males and 5% females with a mean age of 49 years. CSA with Positive Stress Test were 70%, 10% had Unstable Angina and 20% presented with Myocardial Infarction with Positive Troponin. Dynamic ECG changes were present in 30% of the cases. Analysing the risk factors, most of the patients had uncontrolled hypertension (80%) and also were smokers (55%). Diabetes was prevalent in 55% of cases and dyslipidemia in 30% of cases. There were no mortalities noted in hospitalised patients.
The American Journal of Cardiologyâ APRIL 23e26, 2013 ANGIOPLASTY SUMMIT ABSTRACTS/Poster
Invasive Coronary Imaging: IVUS, OCT, Spectroscopy, and Other Thursday, April 25, 2013 8:30 AM w 12:30 PM (Abstract nos. AS-168, AS-169, AS-170, AS-171, AS-172, AS-173, AS-174, AS-175) - AS-168 Clinical and Angiographic Features of Coronary Ostial Lesion with a Damping of the Pressure Tracing. Soe Hee Ann, Jun Ho Lee, Jong Min Kim, Shin-Jae Kim, Eun-Seok Shin. Ulsan University Hospital, Ulsan, Korea (Republic of). Background: When performing coronary angiography, diagnostic catheter intubation of the ostium often leads to a damping of the pressure tracing. Although catheter induced coronary spasm is suggested as the main mechanism of damping, atherosclerotic ostial lesion may be the one of the differential diagnoses. The purpose of this retrospective study is to find out the risk factors of ostial lesion in patients showing pressure damping during coronary angiography. Methods: Among 2,926 consecutive patients who underwent diagnostic coronary angiography from September 2010 to March 2012 in a single center, 76 ostium in 67 patients (incidence, 2.2%) were recorded as a damping of the pressure tracing. Pressure damping was defined as abrupt decrease of the coronary blood pressure with blunted pulse pressure after the engagement of diagnostic catheter. We divided 2 groups with atherosclerotic ostial lesion (n¼31) and ostial non-lesion (n¼45) using angiography and intravascular ultrasound (IVUS). We compared the clinical and angiographic characterisitics between the 2 groups and analysed using IVUS Virtual Histology (IVUS-VH). Results: Ostial lesion group showed more frequent familial history of cardiovascular disease and pressure damping of left main ostium than ostial non-lesion group. Percutaneous coronary intervention (PCI) on damped ostium was performed more frequently in ostial lesion group than ostial non-lesion group (n¼20 (64.5%) vs. n¼14 (31.1%), p¼0.004). PCI on damped ostium had more frequent another atherosclerotic lesion (diameter stenosis > 50%, n¼14 (35.0%)) than non-PCI group (n¼0). In IVUS, ostial lesion group showed prominent plaque burden and IVUSVH showed that fibrous tissue was more dominant plaque component in ostial lesion group than ostial non-lesion group. Table Gray scale, VH-IVUS findings Variables F volume/plaque (%) FF volume/plaque (%) NC volume/plaque (%) DC volume/plaque (%)
Ostial Lesion (Left. n¼ 11)
Ostial Lesion (Right, n¼13)
P- value
66.58.8 12.95.9 15.07.9 5.74.2
65.511.1 16.69 1 12.38.8 5.68.2
0.81 0.25 0.45 0.98
Conclusion: During the coronary angiography, ostial pressure damping is not rare. When we meet another atherosclerotic lesion other
than pressure damped ostium, the ostium might be significant atherosclerotic lesion. So more detailed coronary evaluation like IVUS is needed in a patient of pressure damped ostium with another site of atherosclerotic lesion.
- AS-169 Clinical, Angiographic, and Intravascular Ultrasound Predictors of Early Stent Thrombosis in Patients with Acute Myocardial Infarction. Young Joon Hong, Myung Ho Jeong, Yun Ha Choi, Soo Young Park, Hae Chang Jeong, Jae Yeong Cho, Soo Young Jang, Sang Cheol Cho, Jong Hyun Yoo, Keun Ho Park, Doo Sun Sim, Ju Han Kim, Youngkeun Ahn, Jeong Gwan Cho, Jong Chun Park, Jung Chaee Kang. Chonnam National University Hospital, Gwangju, Korea (Republic of). Background: The clinical, angiographic, and intravascular ultrasound predictors of early stent thrombosis (EST including acute and subacute ST) in acute myocardial infarction (AMI) patients are still not well known. The purpose of this study was to find out predictors of EST in patients with 418 AMI patients (155 ST segment elevation and 263 nonST segment elevation MI). Methods: All patients received 300 mg (for non-ST segment elevation MI) or 600 mg (ST segment elevation MI) of clopidogrel loading at emergency department and dual antiplatelet therapy was used in all patients at least 1 month after stent implantation (260 drug-eluting stents and 158 bare-metal stents). Results: EST occurred in 16 patients (3.8%). Pre-intervention peak cardiac specific troponin-I (cTnI) was significantly higher (4070 ng/mL vs. 1135 ng/mL, p¼0.002), and plaque rupture (62.5% vs. 34.1%, p¼0.020), thrombi (62.5% vs. 24.4%, p¼0.001), and post-stenting tissue prolapse (68.8% vs. 32.6%, p¼0.003) were observed more frequently in EST group than non-EST group. No-reflow during or after percutaneous coronary intervention was developed more frequently in EST group than non-EST group (87.5% vs. 12.2%, p<0.001). Multivariate analysis showed that no-reflow [odds ratio (OR)¼36.311; 95% confidence interval (CI) 7.218-182.677, p<0.001], pre-intervention peak cTnI (OR¼1.012; 95% CI 1.003-1.021, p¼0.009), and tissue prolapse (OR¼3.203; 95% CI 1.156-8.801, p¼0.029) were the independent predictors of EST. Conclusion: The incidence of EST after stenting of infarct-related arteries was 3.8%. No-reflow, pre-PCI peak cTnI and tissue prolapse were associated with the development of EST after stent implantation in patients with AMI.
- AS-170 Multi-modality Imaging for Stent Edge Assessment. Soe Hee Ann, Jun Ho Lee, Jong Min Kim, Shin-Jae Kim, Eun-Seok Shin. Ulsan University Hospital, Ulsan, Korea (Republic of). Background: Optical coherence tomography (OCT) has a high resolution of approximately 10 mm allowing superior assessment of dissection at the stent edge. The aims of the present study were 1) to evaluate the frequency of edge dissection after stenting by optical coherence tomography (OCT), 2) to compare the incidence of stent edge dissection between angiogram, intravascular ultrasound (IVUS) and OCT, 3) to evaluate plaque composition using IVUS Virtual Histology (IVUS-VH) at the site of stent edge dissections detected by OCT after percutaneous coronary intervention (PCI). Methods: Thirty six consecutive patients (36 lesions: 57 stent edges) who underwent balloon-expandable stent implantation and post stent assessment with OCT and IVUS-VH were included. Results: OCT identified stent ED in 33.3% (19 of 57) of stent edges after PCI with a balloon-expandable stent. Compared with OCT, edge dissections were detected in only 1.8% (1 of 57) of stent edges using angiography and 5.3% (3 of 57) of stent edges using IVUS. Absolute dense calcium, and
The American Journal of Cardiologyâ APRIL 23e26, 2013 ANGIOPLASTY SUMMIT ABSTRACTS/Poster
83B
P O S T E R A B S T R A C T S
APRIL 23e26, 2013 percent necrotic core (22.87.7% vs. 15.411.1%, p¼0.01) and dense calcium volume (3.42.5 mm3 vs. 1.72.8 mm3, p¼0.03) were greater in the ED group than in the non-ED group by IVUS-VH. One patient had implantation of an additional stent to treat the ED during the index PCI.
Angiography Edge dissection Edge dissection IVUS Edge dissection Edge dissection
Edge Dissection by OCT (n¼19)
Non-Edge Dissection by OCT (n¼38)
(+) (-)
1 (1.8%) 18
2 36
(+) (-)
3 (5.3%) 16
0 38
Conclusion: OCT is superior to conventional coronary angiography and IVUS in the identification of stent ED. The risk of ED may be reduced if underlying plaque composition is considered when assessing stent length thereby ensuring that stent landing zones are free of calcium and necrotic core.
- AS-171 Efficacy of Using Non Slip Element Balloon (Lacrosse NSE) to Treatment for In-stent Restenosis Lesion. Optical Coherence Tomography Analysis. Nobuyuki Miyai, Keisuke Oota, Reo Nakamura, Takayoshi Sawanishi, Noriyuki Kinoshita, Katsushige Matsumoto. Kouseikai Takeda Hospital, Kyoto, Japan.
P O S T E R A B S T R A C T S
Background: Drug-eluting stents (DES) have been shown to reduce restenosis rates. However, restenosis after DES implantation is still observed. In this study, we evaluated the efficacy of non slip element balloon (NSE) for target lesion revascularization (TLR) of in-stent restenosis (ISR). Methods: We enrolled 71 patients who underwent TLR for ISR using NSE. We succeeded in performing angiographic follow-up in 58 patients. We classified these patients into a re-restenosis group and a non re-restenosis group. We compared OCT images of pre-procedure with images of post-procedure. Results: Recurrent restenosis was angiographically documented in 18 patients (31%), and TLR was in 17patients (29%). There were no difference in gender, age, and coronary risk factor between a re-restenosis group and a non re-restenosis group. QCA data before and after procedure were not difference between two groups. Tissue coverage structures in stent, for example homogeneous, heterogeneous, and layered, were not difference between two groups. However, peri-stent low signal area had a tendency to be more detected in re-restenosis group compared with non re-restenosis group (73% vs. 32%, p¼0.072). After NSE angioplasty, we detected fissures in 73% of patients. Irregular lumen shape had tendency to be more detected in re-resteosis group (55% vs. 16%, p¼0.069). Stent area change after using NSE was bigger in non re-restenosis group than re-restenosis group (1.67◇ 0.66mm2 vs. 0.52◇ 0.38mm2, p¼0.0039). Conclusion: A treatment with NSE for ISR lesion may be more effective compared with plain old balloon angioplasty.
- AS-172 Clinical Profile of Spontaneous Coronary Dissection in a Community Hospital. Mathew Ravi Cherian, Balasubramaniyan Amirtha Ganesh, Palamalai Arun Prasath. Mahatma Gandhi Medical College and Research Institute, Puducherry, India.
84B
Background: Spontaneous Coronary Artery Dissection (SCAD) is a rare, infrequent cause of Acute Coronary Syndrome which has been reported frequently in young female with free of atheromatous risk factors. Recent reports highlights the varying trend in the incidence of SCAD different from which was predicted. Methods: A total of 300 patients were analysed over a period of 1 year out of which 10 patients had Spontaneous Coronary Artery Dissection (SCAD) who presented to us with Acute Coronary Syndrome (ACS). Presence of SCAD was confirmed by different orthogonal views during Coronary Angiogram which is usually seen as longitudinal ill filling defects. 70% of the cases were non flow limiting lesions which were medically managed and other 30% cases under went Revascularization. Results: The mean age of presentation was 55 years of which all were males. All the patients were smokers and diabetic, with 4% having Hypertension grade II. 70% (7) of the patients presented with Myocardial Infarction, 30% (3) Unstable Angina. Out of 70% of cases of Myocardial Infarction 57% (4) had Anterior Wall Myocardial Infarction of which 75% (3) had involvement of the Left Anterior Descending Artery Territory and 25% (1) had involvement of the Right Coronary Artery. 43% (3) of the cases had Inferior Wall Myocardial Infarction out of which 33% (1) had involvement of Right Coronary Artery and 67% (2) had Left Anterior Descending artery involvement. 43% (3) of SCAD was seen in non culprit arteries. The mean follow up was for 1 year and all the patients are doing well. Conclusion: SCAD is a rare disease which usually involves the young women, but ours were all middle aged males. Left Anterior Coronary artery dissection is the most common location. SCAD can be seen in non culprit arteries also which are incidentally detected during Coronary Angiogram needing revascularization. Intravascular Ultrasonography is an extremely useful tool to evaluate SCAD, which was not done in our setup for economical reasons. This study emphasis the varying clinical profile of SCAD and its prompt identification.
- AS-173 Clinical Profile of Coronary Slow Flow Phenomenon. Mathew Ravi Cherian, Palamalai Arun Prasath, Balasubramaniyan Amirtha Ganesh. Mahatma Gandhi Medical College and Research Institute, Puducherry, India. Background: Coronary slow flow phenomenon (CSFP) is characterized by delayed progression of the contrast medium injected through the coronary tree during Coronary Angiogram (CAG). CSFP is usually observed in patient with various spectrum of Coronary Artery Disease including Acute Coronary Syndrome and Chronic Stable Angina (CSA). The exact pathogenesis of CSFP is unknown, but 80% of patients experience recurrent episodes of typical anginal pain which results in impairment of quality of the life. Methods: We analysed a total of 20 patients over a period of 6 months with Non Obstructive coronaries below the age group of 60 yrs who presented with Ischemic Heart Disease. Coronary Slow Flow was identified using thrombolysis in myocardial infarction frame count (TFC) method introduced by Gibson. Risk factors and profiles of all the patients were studied in detail. Those patients who had Coronary Artery ectasia and coronary aneurysm were excluded. Results: Out of 20 patients presented with CSFP 95% were males and 5% females with a mean age of 49 years. CSA with Positive Stress Test were 70%, 10% had Unstable Angina and 20% presented with Myocardial Infarction with Positive Troponin. Dynamic ECG changes were present in 30% of the cases. Analysing the risk factors, most of the patients had uncontrolled hypertension (80%) and also were smokers (55%). Diabetes was prevalent in 55% of cases and dyslipidemia in 30% of cases. There were no mortalities noted in hospitalised patients.
The American Journal of Cardiologyâ APRIL 23e26, 2013 ANGIOPLASTY SUMMIT ABSTRACTS/Poster