Relationship between neointimal strut bridge and jailed side-branch ostial area

Abstract

Our study analyzed the relationship between the neointimal strut bridge and jailed side-branch (SB) ostial area in patients with coronary heart disease (CHD) who had a single drug-eluting stent (DES) crossover of the left anterior descending coronary artery (LAD)/diagonal branch (D) bifurcation. A total of 64 CHD patients with an LAD/D bifurcation treated by optical coherence tomography (OCT)-guided single-DES implantation and followed up at 1 year after primary percutaneous intervention (pPCI) were enrolled in our study. According to the two-dimensional OCT results, patients were divided into a non-neointimal bridge group (n\u202f=\u200944) and a neointimal bridge group (n\u202f=\u200920). Basic clinical, angiographic, 2D and 3D OCT, and DES results were analyzed. The blood lipid levels of the two groups after the 1‑year follow-up were lower than the levels 1 year earlier (p\u202f<\u20090.05). There was a notable decrease in the SB ostial minimum lumen diameter and area directly after pPCI vs. before pPCI in both groups. The diameter stenosis directly after pPCI showed a clear increase compared with the pre-pPCI value in both groups (p\u202f<\u20090.05 or p\u202f<\u20090.01, respectively). The strut distance of the neointimal bridges in the neointimal bridge group was greater than in the non-neointimal bridge group (p\u202f<\u20090.05). A clearly short strut distance of the neointimal bridge was observed compared with the strut distance of the non-neointimal bridge in the neointimal bridge group (p\u202f<\u20090.05). A larger neointimal bridge area and a smaller SB ostial area were found in the neointimal bridge group compared with the non-neointimal bridge group (p\u202f<\u20090.05 or p\u202f<\u20090.01, respectively). A short strut distance facilitated formation of a neointimal bridge, which significantly influenced the SB ostial area after single crossover stenting of the SB orifice at the 1‑year follow-up.