Study on risk factors for reduction of branch opening area after immediate of coronary stent implantation

Yin Weijun; Liu Wei; Yang Wentao; Lan Yonghao

doi:10.3760/j.issn.1673-4777.2025.09.002

Abstract：Objective To explore the risk factors for reduction in branch opening area during coronary stent implantation immediate by combining high-precision intracavitary imaging techniques with functional studies.Methods Patients who underwent coronary angiography and stent interventional therapy at Beijing Jishuitan Hospital,Capital Medical University from October 22,2022 to June 1,2023 were selected.Based on the criterion that the reduction ratio of the postoperative branch opening area measured by endovascular imaging exceeded 50％,the lesions were divided into the postoperative branch opening area reduction group(53 cases)and the postoperative branch opening area normal group(113 cases).The differences in various angiographic features and endovascular imaging indicators of the two groups of lesions were compared,and the virtual coronary flow reserve fraction(Angio-FFR)at each point of the main branch of the bifurcated lesion was measured.The independent risk factors for the reduction of branch opening area were analyzed.The receiver operating characteristic(ROC)curve was established to evaluate the predictive value of intracavitary imaging for the reduction of branch opening area.Results There was no significant difference in coronary angiography data between the two groups(all P＞0.05).The proportion of plaque rupture/erosion,healing plaque and calcification in the opening area reduction group were lower than those in the opening area normal group,and the bifurcation angle and the minimum lumen area of the bifurcation nucleus were lower than those in the opening area normal group(all P＜0.05).The results of ROC curve analysis showed that the area under the curve predicted by ΔAngio-FFR for the reduction of branch opening area was 0.80(P＜0.001).The results of multivariate Logistic regression analysis showed that healing plaque,bifurcation calcification and cross bifurcation ΔAngio-FFR were the risk factors for the reduction of branch opening area(all P＜0.05).Conclusion The healing plaque,bifurcation calcification and cross bifurcation ΔAngio-FFR in the bifurcation junction area are the risk factors for the reduction of branch opening area after surgery.ΔAngio-FFR≥0.04 across the bifurcated vascular segment can better predict the reduction of the branch opening area after stent implantation.