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

Catheter Cardiovasc Interv. 2016 Dec;88(7):1067-1074. doi: 10.1002/ccd.26613. Epub 2016 Jun 3.

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. © 2016 Wiley Periodicals, Inc.

Keywords: coronary artery disease; intravascular ultrasound; percutaneous coronary intervention.

MeSH terms

  • Aged
  • Aneurysm, False / drug therapy
  • Aneurysm, False / etiology
  • Angioplasty, Balloon, Coronary / adverse effects
  • Angioplasty, Balloon, Coronary / instrumentation*
  • Cardiac Catheters*
  • Contrast Media / administration & dosage
  • Coronary Angiography
  • Coronary Artery Bypass / adverse effects
  • Coronary Artery Disease / diagnostic imaging
  • Coronary Artery Disease / therapy*
  • Coronary Stenosis / diagnostic imaging
  • Coronary Stenosis / therapy*
  • Equipment Design
  • Fluoroscopy
  • Graft Occlusion, Vascular / diagnostic imaging
  • Graft Occlusion, Vascular / etiology
  • Graft Occlusion, Vascular / therapy*
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / etiology
  • Radiography, Interventional / methods
  • Retrospective Studies
  • Saphenous Vein / diagnostic imaging
  • Saphenous Vein / transplantation
  • Stents
  • Texas
  • Thrombin / administration & dosage
  • Time Factors
  • Treatment Outcome
  • Ultrasonography, Interventional

Substances

  • Contrast Media
  • Thrombin