Abstract
Abstract Background Excimer laser coronary angioplasty (ELCA) is reported to provide a good percutaneous coronary intervention (PCI) outcome. The current lineups of laser catheter sizes are 0.9-mm, 1.4-mm, and 1.7-mm catheter diameters. Although the cross ability and irradiation time is better in smaller catheter size, the available irradiation area is more significant in larger catheter size; however, it is unknown the difference in laser catheter size impacts good results in patients with ST-elevation myocardial infarction (STEMI). Aim To investigate the relationship between the laser catheter size and clinical outcome in patients with STEMI. Methods and Results We retrospectively enrolled 123 consecutive patients with STEMI who underwent primary PCI (median age: 67 [69-72] years, male: 102 [82.9%]). Patients were divided into 0.9-mm-catheter diameter group (small group, n = 47) and 1.4/1.7-mm-catheter diameter group (large group, n = 76). The patients’ characteristics, procedural results, peak creatine kinase/ creatinine kinase-myocardial band, final thrombolysis in myocardial infarction flow, and periprocedural complications were collected. Furthermore, from nuclear scintigraphy data based on a 17-segment model with a 5-point scoring system, which was calculated via the difference between 123I-BMIPP at 3-7 days and 99mTc-tetrofosmin at 3-6 months following PCI, the improvement of ejection fraction (EF) and myocardial salvage through summed rest score (SRS) were investigated. There was no significant difference in patients’ characteristics, PCI procedure, and results between the two groups. The occurrence of coronary slow flow was similar between the two groups. On the other hand, nuclear scintigraphy data demonstrated that the improvement of EF and SRS were significantly better in the small group (EF; 13.3% vs. 7.6%, p=0.016, SRS; 18 vs. 5, p=0.012, respectively). Conclusions The nuclear scintigraphy findings showed that ELCA with small catheter size is feasible in patients with STEMI.Figure 1
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