c. Post dilation Post dilation of the stented segment should be performed with a non compliant PTCA balloon. Balloon diameter, nominal PTCA balloon diameter needs to be chosen to achieve a balloon to stent ratio of 1,one at high pressure. d. DEB dilation DEB length and positioning, DEB length should be 10 mm longer compared to the previously deployed stent and centered within this kind of pre handled length. DEB inflation time, 45 seconds. Balloon to stent ratio, 1. 1,one at a stress close or slightly larger from the DEB nominal pressure. The angiographic results with the procedure might be assessed by 3 dimensional quantitative coronary angiography utilizing the Paieon Cardi Op procedure. Post procedural management Cardiac injury markers will be assessed just before the procedure, and 6 hours and 24 hours right after PCI.
Thereafter, even further blood samples will probably be carried out only if clinically indicated. Just after PCI, sufferers will be given aspirin and lifestyle prolonged clopidogrel for three months. Observe up Clinical follow up will take place at one month, six months and 1 12 months by clinical visit or cell phone interview. With the 6 month buy inhibitor stick to up, all individuals will undergo a coronary angiography and an OCT examine. We anticipate a patient drop out charge of 10%. Rationale for optical coherence tomography choice and description of optical coherence tomography analysis For many many years, QCA has been used to assess regression and progression of coronary obstructions in pharmaco logical interventions, to assess the efficacy of PCI and stenting, and for vessel sizing.
Nonetheless, QCA late lumen reduction would be the distinction concerning two minimal lumen selleckchem diam eter measurements at two different instances, as well as the axial place of this diameter is variable at every time stage. An angiogram only examines the lumen, although the dis ease is from the vessel wall. These limitations have spurred the hunt for new intravascular diagnostic imaging tech niques. A meta evaluation of QCA versus intravascular ultrasound parameters for assessing stent resten osis showed by regression evaluation that QCA late lumen loss and percentage of diameter stenosis corre lates only moderately with IVUS evaluation of neointimal hyperplasia. A recent operate evaluated the correlation of angiographic late loss with the degree of in stent neointimal proliferation assessed by OCT, demonstrating a bad correlation of angiographic late loss with OCT at minimal degrees of neointimal proliferation. The detection from the publish stent implantation intima by OCT and IVUS has also been in contrast. Right after a median stick to up time of 6 months, Matsumoto et al. examined the response with the intima by OCT and discovered that 64% on the struts had become covered with an intima a hundred um thick. The correl ation concerning OCT and histology measurements was stronger than the correlation involving IVUS and histology.