Predictive performance of dual modality of computed tomography angiography and intravascular ultrasound for no-reflow phenomenon after percutaneous coronary stenting in stable coronary artery disease

• DOI: 10.1007/s00380-018-1160-2
• Publication Date: 2018-04-11T08:15:15Z
• Authors: Masaaki Okutsu; Takeshi Horio; Hisataka Tanaka; Maki Akiyama; Niro Okimoto; Toshiyuki Tsubouchi; Kenji Kawajiri; Yasuhiro Ohashi; Satoru Sumitsuji; Yuji Ikari
• Keywords: Intravascular Ultrasound; No reflow phenomenon; Computed Tomography Angiography; Fractional Flow Reserve; Hounsfield scale

Attenuated plaque on intravascular ultrasound (IVUS) and low attenuation computed tomography angiography (CTA) are associated with no-reflow phenomenon during percutaneous coronary intervention (PCI). However, evaluation by a single modality has been unable to satisfactorily predict this phenomenon. We investigated whether the combination of IVUS CTA findings can ameliorate predictive potential for after stent implantation PCI in stable artery disease (CAD). A total 988 lesions 707 CAD patients who underwent before were enrolled. was performed preprocedural implantation. As characters, very (CTA v-LAP) whose minimum density < 0 Hounsfield units attenuated (IVUS AP) evaluated. No-reflow observed 22 (2.2%) 19 (2.7%). Both v-LAP AP much more frequently Positive (PPV) negative values (NPV) accuracy prediction almost equivalent between (13.2, 99.6, 87.0%) (15.7, 99.8, 89.0%). The markedly ameliorated PPV (31.7%) without deterioration NPV (99.7%) increased diagnostic (95.5%). These showed that improved power stenting patients, suggesting usefulness combined estimation using predicting clinical practice.