Comparision between Direct Stenting and Stenting after Pre-dilatation Using TIMI Frame Count in Stable Coronary Artery Disease

EKİNCİ, Mehmet Akif; ARSLAN, Abdurrahman; AKDENİZ, Bahri; ÜNAL, Barış; KOYUNCU, Betül; ŞENARSLAN, Ömer; EYÜBOĞLU, MEHMET; Koyuncu, İlhan; AYTEMİZ, Fatih

Comparision between Direct Stenting and Stenting after Pre-dilatation Using TIMI Frame Count in Stable Coronary Artery Disease

Mehmet EYÜBOĞLU, (Avrupa Tıp Merkezi, Kardiyoloji Kliniği, İzmir, Türkiye)

Bahri AKDENİZ, (Dokuz Eylül Üniversitesi, Tıp Fakültesi, Kardiyoloji Anabilim Dalı, İzmir, Türkiye)

Ömer ŞENARSLAN, (Şifa Üniversitesi, Tıp Fakültesi, Kardiyoloji Anabilim Dalı, İzmir, Türkiye)

Mehmet Akif EKİNCİ, (Alfa Kalp Tıp Merkezi, Kardiyoloji Kliniği, İzmir, Türkiye)

Abdurrahman ARSLAN, (Bartın Devlet Hastanesi, Kardiyoloji Kliniği, Bartın, Türkiye)

Fatih AYTEMİZ, (Dokuz Eylül Üniversitesi, Tıp Fakültesi, Kardiyoloji Anabilim Dalı, İzmir, Türkiye)

İlhan KOYUNCU, (Uşak Devlet Hastanesi, Kardiyoloji Kliniği, Uşak, Türkiye)

Betül KOYUNCU, (İzmir Katip Çelebi Üniversitesi, Tıp Fakültesi, İç Hastalıkları Anabilim Dalı, İzmir, Türkiye)

Barış ÜNAL (Dokuz Eylül Üniversitesi, Tıp Fakültesi, Kardiyoloji Anabilim Dalı, İzmir, Türkiye)

Koşuyolu Heart Journal

2 0

Yıl: 2015 Cilt: 18 Sayı: 3 Sayfa Aralığı: 130 - 134 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Comparision between Direct Stenting and Stenting after Pre-dilatation Using TIMI Frame Count in Stable Coronary Artery Disease

Öz:

Giriş: Stabil koroner arter hastalığında doğrudan stent ve perkütan translüminal koroner anjiyoplasti (PTKA) sonrasında stentleme yöntemlerinin koroner kan akımı üzerine etkisini karşılaştıran yeterli veri yoktur. Çalış- mamızda, doğrudan stent ve PTKA sonrası stentleme yöntemlerinin koroner kan akımı üzerine etkisi TIMI kare sayısı (TKS) kullanılarak karşılaştırıldı. Hastalar ve Yöntem: 2008-2012 yılları arasında perkütan koroner girişim (PKG) yapılan hastalar taranarak, doğrudan stentleme uygulanmış 55 hasta ve PTKA sonrası stentleme uygulanmış 42 hasta çalışmaya alındı. Hastaların PKG kayıtları izlendi. Her hasta için işlem öncesi ve sonrası TKS hesaplandı. İki tedavi grubu işlem öncesi ve sonrası TKS açısından karşılaştırıldı. Bulgular: Doğrudan stent grubunda ortalama TKS işlem öncesinde 18.72 kare/saniye, işlem sonrasında 16.12 kare (fark 2.6 kare/saniye) bulundu; PTKA sonrası stent grubunda ise bu değerler sırasıyla 18.13 kare/saniye ve 16.63 kare/saniye (fark 1.5 kare/saniye) idi. İşlem sonrası TKS'deki azalma açısından iki grup arasındaki fark anlamlı idi (p< 0.001). Sonuç: Bulgularımız, stabil koroner arter hastalığında doğrudan stentleme yönteminin koroner kan akımını iyileştirmede PTKA sonrası stentlemeye göre daha başarılı olduğunu gösterdi. Bu bulgu, doğrudan stentleme ile daha iyi mikrovasküler dolaşım sağlandığını düşündürmektedir.

Anahtar Kelime:

Konular: Kalp ve Kalp Damar Sistemi

Stabil Koroner Arter Hastalığında Doğrudan Stentleme ve Ön-dilatasyon Sonrası Stentleme Yöntemlerinin TIMI Kare Sayısı Kullanılarak Karşılaştırılması

Öz:

Introduction: There are limited data comparing the effects of direct stenting and stenting after balloon percutaneous transluminal coronary angioplasty (PTCA) on coronary fl ow in patients with stable coronary artery disease (CAD). This study was designed to evaluate the effects of direct stenting and stenting after balloon PTCA on coronary fl ow using TIMI frame count (TFC) in patients with stable CAD. Patients and Methods: After a retrospective review of patients who underwent percutaneous coronary intervention (PCI) from 2008 to 2012, we identifi ed and included 55 patients who underwent direct stenting and 42 patients who received stenting after balloon PTCA. PCI records of the two study groups were reviewed to re-calculate pre- and post-PCI TFCs for comparison. Results: The average pre- and post-procedural TFC values were 18.72 frames per second (fps) and 16.12 fps (difference 2.6 fps), respectively, in the direct stenting group. The corresponding TFC values were 18.13 fps and 16.63 fps (difference 1.5 fps) in the stenting after balloon PTCA group. The two groups differed signifi cantly with respect to post-procedural decreases in TFC (p< 0.001). Conclusion: Our fi ndings show that, compared to stenting after balloon PTCA, direct stenting is more successful in terms of improved antegrade coronary blood fl ow in stable CAD patients, which suggests that direct stenting may contribute to better microvascular circulation.

Anahtar Kelime:

Konular: Kalp ve Kalp Damar Sistemi

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

Martinez-Elbal L, Ruiz-Nodar JM, Zueco J, López-Minguez JR, Moreu J, Calvo I, et al. Direct coronary stenting versus stenting with balloon pre- dilation: immediate and follow-up results of a multicentre, prospective, randomized study. The DISCO trial. Direct stenting of coronary arteries. Eur Heart J 2002;23:633-40.
Weber F, Schneider H, Warzok F, Petzsch M, von Knorre GH, Nienaber CA. Randomized comparison of direct and provisional stenting in de novo coronary artery lesions: the RADICAL study. Z Kardiol 2003;92:173-81.
Özdemir R, Sezgin AT, Barutcu I, Topal E, Güllü H, Açıkgöz N. Comparison of direct stenting versus conventional stent implantation on blood fl ow in patients with ST-segment elevation myocardial infarction. Angiology 2006;57:453-8.
Gibson CM, Cannon CP, Daley WL, Dodge JT Jr, Alexander B Jr, Marble SJ, et al. TIMI frame count: a quantitative method of assessing coronary artery fl ow. Circulation 1996;93:879-88.
Rogers C, Karnovsky MJ, Edelman ER. Inhibition of experimental neointimal hyperplasia and thrombosis depends on the type of vascular injury and the site of drug administration. Circulation 1993;88:1215-21.
Schwartz RS, Huber KC, Murphy JG, Edwards WD, Camrud AR, Vlietstra RE, et al. Restenosis and the proportional neointimal response to coronary artery injury: results in a porcine model. J Am Coll Cardiol 1992;19:267-74.
Alidoosti M, Salarifar M, Kassaian SE, Zeinali AM, Fathollahi MS, Dehkordi MR. In-hospital and mid-term adverse clinical outcomes of a direct stenting strategy versus stenting after predilatation for the treatment of coronary artery lesions. Cardiovasc J Afr 2008;19:297-302.
Baim DS, Flatley M, Caputo R, O'Shaughnessy C, Low R, Fanelli C, et al. Comparison of PRE-dilatation vs direct stenting in coronary treatment using the Medtronic AVE S670 Coronary Stent System (The PREDICT trial). Am J Cardiol 2001;88:1364-9.
Danzi GB, Capuano C, Fiocca L, Dallavalle F, Pirelli S, Mauri L, et al. Stent implantation without predilation in patients with a single, noncalcifi ed coronary artery lesion. Am J Cardiol 1999;84:1250-3.
Le Breton H, Boschat J, Commeau P, Brunel P, Gilard M, Breut C, et al. Randomized comparison of coronary stenting with and without balloon predilatation in selected patients. Heart 2001;86:302-8.
Balachandran KP, Singh B, Sandilands A, Popusoi G, Rubino P, Baumbach A. Functional result following direct coronary artery stenting with drug eluting stents in chronic stable angina is similar to stenting after balloon predilatation. Int J Cardiol 2008;128:374-7.
Balducelli M, Varani E, Vecchi G, Paloscia L, Manari A, Santarelli A, et al. Direct coronary stenting versus stenting with balloon pre-dilation: incidence of enzyme release and follow-up results of a multicentre, prospective, randomized study. The CK and Troponin I Estimation in direct STenting (CK TEST) trial. Minerva Cardioangiol 2007;55:281-9.

APA	EYÜBOĞLU M, AKDENİZ B, ŞENARSLAN Ö, EKİNCİ M, ARSLAN A, AYTEMİZ F, Koyuncu İ, KOYUNCU B, ÜNAL B (2015). Comparision between Direct Stenting and Stenting after Pre-dilatation Using TIMI Frame Count in Stable Coronary Artery Disease. , 130 - 134.
Chicago	EYÜBOĞLU MEHMET,AKDENİZ Bahri,ŞENARSLAN Ömer,EKİNCİ Mehmet Akif,ARSLAN Abdurrahman,AYTEMİZ Fatih,Koyuncu İlhan,KOYUNCU Betül,ÜNAL Barış Comparision between Direct Stenting and Stenting after Pre-dilatation Using TIMI Frame Count in Stable Coronary Artery Disease. (2015): 130 - 134.
MLA	EYÜBOĞLU MEHMET,AKDENİZ Bahri,ŞENARSLAN Ömer,EKİNCİ Mehmet Akif,ARSLAN Abdurrahman,AYTEMİZ Fatih,Koyuncu İlhan,KOYUNCU Betül,ÜNAL Barış Comparision between Direct Stenting and Stenting after Pre-dilatation Using TIMI Frame Count in Stable Coronary Artery Disease. , 2015, ss.130 - 134.
AMA	EYÜBOĞLU M,AKDENİZ B,ŞENARSLAN Ö,EKİNCİ M,ARSLAN A,AYTEMİZ F,Koyuncu İ,KOYUNCU B,ÜNAL B Comparision between Direct Stenting and Stenting after Pre-dilatation Using TIMI Frame Count in Stable Coronary Artery Disease. . 2015; 130 - 134.
Vancouver	EYÜBOĞLU M,AKDENİZ B,ŞENARSLAN Ö,EKİNCİ M,ARSLAN A,AYTEMİZ F,Koyuncu İ,KOYUNCU B,ÜNAL B Comparision between Direct Stenting and Stenting after Pre-dilatation Using TIMI Frame Count in Stable Coronary Artery Disease. . 2015; 130 - 134.
IEEE	EYÜBOĞLU M,AKDENİZ B,ŞENARSLAN Ö,EKİNCİ M,ARSLAN A,AYTEMİZ F,Koyuncu İ,KOYUNCU B,ÜNAL B "Comparision between Direct Stenting and Stenting after Pre-dilatation Using TIMI Frame Count in Stable Coronary Artery Disease." , ss.130 - 134, 2015.
ISNAD	EYÜBOĞLU, MEHMET vd. "Comparision between Direct Stenting and Stenting after Pre-dilatation Using TIMI Frame Count in Stable Coronary Artery Disease". (2015), 130-134.

APA	EYÜBOĞLU M, AKDENİZ B, ŞENARSLAN Ö, EKİNCİ M, ARSLAN A, AYTEMİZ F, Koyuncu İ, KOYUNCU B, ÜNAL B (2015). Comparision between Direct Stenting and Stenting after Pre-dilatation Using TIMI Frame Count in Stable Coronary Artery Disease. Koşuyolu Heart Journal, 18(3), 130 - 134.
Chicago	EYÜBOĞLU MEHMET,AKDENİZ Bahri,ŞENARSLAN Ömer,EKİNCİ Mehmet Akif,ARSLAN Abdurrahman,AYTEMİZ Fatih,Koyuncu İlhan,KOYUNCU Betül,ÜNAL Barış Comparision between Direct Stenting and Stenting after Pre-dilatation Using TIMI Frame Count in Stable Coronary Artery Disease. Koşuyolu Heart Journal 18, no.3 (2015): 130 - 134.
MLA	EYÜBOĞLU MEHMET,AKDENİZ Bahri,ŞENARSLAN Ömer,EKİNCİ Mehmet Akif,ARSLAN Abdurrahman,AYTEMİZ Fatih,Koyuncu İlhan,KOYUNCU Betül,ÜNAL Barış Comparision between Direct Stenting and Stenting after Pre-dilatation Using TIMI Frame Count in Stable Coronary Artery Disease. Koşuyolu Heart Journal, vol.18, no.3, 2015, ss.130 - 134.
AMA	EYÜBOĞLU M,AKDENİZ B,ŞENARSLAN Ö,EKİNCİ M,ARSLAN A,AYTEMİZ F,Koyuncu İ,KOYUNCU B,ÜNAL B Comparision between Direct Stenting and Stenting after Pre-dilatation Using TIMI Frame Count in Stable Coronary Artery Disease. Koşuyolu Heart Journal. 2015; 18(3): 130 - 134.
Vancouver	EYÜBOĞLU M,AKDENİZ B,ŞENARSLAN Ö,EKİNCİ M,ARSLAN A,AYTEMİZ F,Koyuncu İ,KOYUNCU B,ÜNAL B Comparision between Direct Stenting and Stenting after Pre-dilatation Using TIMI Frame Count in Stable Coronary Artery Disease. Koşuyolu Heart Journal. 2015; 18(3): 130 - 134.
IEEE	EYÜBOĞLU M,AKDENİZ B,ŞENARSLAN Ö,EKİNCİ M,ARSLAN A,AYTEMİZ F,Koyuncu İ,KOYUNCU B,ÜNAL B "Comparision between Direct Stenting and Stenting after Pre-dilatation Using TIMI Frame Count in Stable Coronary Artery Disease." Koşuyolu Heart Journal, 18, ss.130 - 134, 2015.
ISNAD	EYÜBOĞLU, MEHMET vd. "Comparision between Direct Stenting and Stenting after Pre-dilatation Using TIMI Frame Count in Stable Coronary Artery Disease". Koşuyolu Heart Journal 18/3 (2015), 130-134.