The effectiveness of percutaneous intermittent coronary sinus occlusion in acute coronary syndrome in patients without ST elevation and non significant coronary arteries stenosis

DOI: https://doi.org/10.25512/DIR.2015.09.3.08

For quoting:
Shakhov E.B. "The effectiveness of percutaneous intermittent coronary sinus occlusion in acute coronary syndrome in patients without ST elevation and non significant coronary arteries stenosis". Journal Diagnostic & interventional radiology. 2015; 9(3); 57-63.

authors:

Shakhov E.B.

keywords:

peripheral angiospasm

non significant coronary stenosis

intermittent coronary sinus occlusion

coronary wedge pressure

blush flow

left anterior descending artery

Abstract:

According to newest clinical studies, 20%-30% of acute coronary syndrome patients without БТ elevation have nonsignificant coronary artery stenosis

Aim: was to estimate the effectiveness of percutaneous intermittent coronary sinus occlusior (ICSO) in acute coronary syndrome patients without БТ elevation and nonsignificant coronary arteries stenosis.

Materials and methods: results of endovascular treatment of patients with acute coronary syndrome patients without БТ elevation, for the period 09.10.2014-02.02.2015 were analyzed. All patients underwent ICSO for 10-13 minutes until intravenous wedge pressure plateau was achieved.

Results: in the beginning of the intervention all patients had nonsignificant coronary arteries stenosis, peripheral coronary angiospasm and slow flow in left anterior descending arteries (LAD): Т1М1 frame count in LAD (TFCLAD) was 85,9±17,6 frm; distal diameter of LAD (DLAD) was 2,1±0,5 mm; quantitative blush evaluation score in LAD (QuBELAD) was 11,8±1,4. After the ICSO procedure coronary hemodynamic was improved: TFCLAD=59,5±9,8 frm; DLAD=2,5±0,4 mm; QuBELAD= 27,4±2,2; p=0,01).

Conclusion: ICSO procedure led to the both improvement of the antegrade blood flow in LAD anc myocardial blush flow and reduction of the peripheral coronary angiospasm. ICSO procedure significantly improved the electrocardiography and clinical conditions.

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