Presence and Relevance of Myocardial Bridge in LAD-PCI of Chronic Total Occlusion (CTO) and Non-CTO Lesions
Authors' conclusion
An MB was more common in LAD CTO than non-CTO LAD lesions. If present, approximately one-half of LAD CTOs had a stent extending into an MB that, in turn, was associated with worse outcomes.
Study context
- Population
- Left anterior descending (LAD) lesions treated with intravascular ultrasound (IVUS)-guided PCI, CTO and non-CTO280 CTO, 3,062 non-CTO lesions
- Participants
- 3,342 LAD lesions
- Exposure
- LAD lesions with vs without myocardial bridge
- Stent into MBn = 55
- CTO without MBn = 167
- Outcome
- Target lesion failure:
- Cardiac death
- Target vessel MI
- Definite stent thrombosis
- Ischemic-driven target lesion revascularization
Methodological detailsIVUS-guided PCI
- IVUS-guided PCI
Main finding
As reported in the abstract
Target lesion failure in LAD CTOs
Stent into MB vs Stent not into MB: P = 0.0004 · Stent into MB vs CTO without MB: P = 0.02
Observational data: associations, not effects.
Further findings
| Outcome | CTO without MB | P value |
|---|---|---|
| MB prevalence by IVUSLAD CTO vs LAD non-CTO | P < 0.0001 | |
| Discrepancy in CTO length, angiography vs IVUS | 0.2 (IQR −1.4–8.4) mm | P < 0.0001 |
- MB prevalence by IVUS: LAD CTO 40.4%
- MB prevalence by IVUS: LAD non-CTO 25.8%
- Discrepancy in CTO length, angiography vs IVUS: CTO with MB 6.0 (IQR 0.1–12.2) mm
- Stent extending into MB among LAD CTOs with MB: CTO with MB 48.7%
Original publication
Presence and Relevance of Myocardial Bridge in LAD-PCI of CTO and Non-CTO Lesions. JACC Cardiovasc Interv. Published 7 February 2024. doi:10.
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