Piotr Kwiatkowski

Use of abciximab prevents microcirculatory impairment in patients treated with coronary angioplasty for unstable angina: Results of a prospective randomized study

The use of abciximab during percutaneous coronary angioplasty (PTCA) in patients with unstable angina (UA) prevents the postintervention enzyme surge and improves clinical outcomes, possibly by improving microcirculatory function. The aim of this quantitative myocardial blush grade (MBG) study was to verify whether abciximab improves postintervention microcirculation in patients with UA. This prospective randomized open‐label study involved 140 UA patients scheduled to undergo PTCA of the target coronary lesion: 140 patients were randomized to receive either abciximab during PTCA (group 1, 70 patients) or conventional treatment without GP IIb/IIIa inhibitor (group 2, 70 patients). The exclusion criteria included above normal CK‐MB levels. MBG was calculated by means of quantitative software that evaluates video intensity in a given region of interest: assuming that greater peak video intensity reflects a larger myocardial blood volume, a perfusion scale of 1–6 points (poor to optimal) was devised. The groups were homogeneous in terms of their demographic, procedural, and angiographic characteristics. Stents were used in 98% of the patients in both groups. The MBG score significantly increased in group 1 from 3.04 ± 2.17 to 3.71 ± 2.02 (P = 0.045) and slightly decreased in group 2 from 3.13 ± 2.07 to 2.93 ± 2.03 (P = 0.42). Consequently, group 1 showed a significantly greater postintervention MBG score (3.71 ± 2.02 vs. 2.93 ± 2.03; P = 0.022) and had a significantly greater MBG score change (P = 0.025). The results of this randomized study show that the administration of abciximab prevents microcirculatory impairment in patients undergoing angioplasty for acute coronary syndromes.

Numerical analysis of crimping and inflation process of balloon-expandable coronary stent using implicit solution

The paper presents an applied methodology for numerical finite element analysis of coronary stent crimping and the free inflation process with the use of a folded noncompliant angioplasty balloon. The use of an implicit scheme is considered as the most original part of the work, as an explicit finite element procedure is very often preferred. Hitherto, when the implicit solution was used for the finite element solution, the simulated issue was largely simplified. Therefore, the authors focused on the modelling methodology with minimum possible simplification, ie, a full load path (compression and inflation in single analysis), solid element discretization, and sophisticated contact models (bodies with highly different stiffness). The obtained results are partially compared with experimental data (radial force during the crimping procedure) and present satisfactory compliance. The authors believe that presented methodology allow for significant improvement of the obtained results, as well as potential extension of the research scope, compared to previous efforts performed using the explicit integration scheme. Moreover, the presented methodology is believed to be suitable for sensitivity and optimization studies.

TCT-325 The effects of types of guidewires and pressure applied during stent implantation in the main vessel on the incidence of damage to coronary guidewires during angioplasty of coronary bifurcation lesions - Wide Beast study

AAST Grande Ospedale Metropolitano Niguarda, Milano, Milan, Italy; AAST Grande Ospedale metropolitano Niguarda Cà Granda, Milano, Milan, Italy; AAST Grande Ospedale Metropolitano Niguarda; AAST Grande Ospedale Metropolitano Niguarda, PIACENZA, Italy; Unknown, Milan, Milan, Italy; Niguarda Hospital; Niguarda Hospital, Milan, Milan, Italy; Niguarda Hospital; Ospedale Niguarda; Hospital U. Central de la Defensa Gómez Ulla

TCT-361 Can we improve the diagnostic efficacy of angiography and intravascular ultrasound in assessing intermediate lesions?

Minimal lumen area (MLA) and minimal lumen diameter (MLD) are the best known parameters of bad prognosis in left main stenosis (LMS). In our prospective study we introduced plaque volume index (PVI=plaque area volume (PAV)/ vessel area volume (VAV)) as an additional parameter patients during IVUS