Procedural outcomes with use of the flash ostial system in aorto-coronary ostial lesions

Phuong Khanh J Nguyen-Trong, Jose Roberto Martinez Parachini, Erica Resendes, Aris Karatasakis, Barbara A. Danek, Aya Alame, Lorenza B. Makke, Colby R. Ayers, Michele Roesle, Bavana Rangan, Subhash Banerjee, Emmanouil S. Brilakis

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

Background: The Flash Ostial system (Ostial Corporation, Sunnyvale, CA) was designed to optimize implantation of aorto-ostial coronary stents by flaring the proximal stent struts against the aortic wall. Methods: We retrospectively reviewed the medical record, angiograms, and intravascular ultrasound images of 22 aorto-ostial percutaneous coronary interventions performed at our institution between March and September 2015. The Flash Ostial system was used in 13 cases (59%). Results: Mean age was 67 ± 8 years and all patients were men. The target vessel was the right coronary artery (59%), left main (27%), or a saphenous vein graft (14%); 59% of the lesions had moderate/severe calcification. The mean number of predilation balloons was 1.8 ± 1.6, mean Flash ostial balloon diameter was 3.3 ± 0.5 mm and mean inflation pressure was 13.1 ± 4.0 atmospheres. Intravascular ultrasonography (available for 19 patients) revealed mean ostial minimum lumen cross-sectional area (MLA) of 9.2 ± 3.0 mm2 and reference MLA of 8.5 ± 2.7 mm2. The percent difference between ostial and reference MLA was higher in cases in which the Flash Ostial system was used versus those where it was not (9.6 ± 5.5% vs. 4.0 ± 2.8%, P = 0.03). All stent struts were well apposed. Technical success was 100%. One patient developed a left groin pseudoaneurysm treated with thrombin injection and one patient had a periprocedural myocardial infarction. Median contrast, fluoroscopy time, and procedure time were 235 mL, 33 min, and 118 min, respectively. Conclusions: The Flash Ostial system can be successfully used in aorto-ostial stenting, resulting in large ostial vessel MLA.

Original languageEnglish (US)
Pages (from-to)1067-1074
Number of pages8
JournalCatheterization and Cardiovascular Interventions
Volume88
Issue number7
DOIs
StatePublished - Dec 1 2016

Keywords

  • coronary artery disease
  • intravascular ultrasound
  • percutaneous coronary intervention

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

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