Impact of size-dependent differences in excimer laser coronary angioplasty in ST-elevation acute myocardial infarction: nuclear scintigraphy findings.

Abstract

Introduction: Excimer laser coronary angioplasty (ELCA) employs catheters of various sizes. Although the crossability and irradiation time are better with the use of smaller-diameter catheters, the available irradiation area is greater when larger-diameter catheters are used.

Aim: To investigate the effects of laser catheter size on myocardial function and salvage in patients with ST-elevation myocardial infarction (STEMI), as assessed using nuclear scintigraphy data.

Material and methods: A total of 123 consecutive patients with STEMI who underwent primary percutaneous coronary intervention (PCI; median age, 67 [69-72] years; males, n = 102 [82.9%]) were retrospectively enrolled. The patients were divided into a 0.9-mm catheter diameter group (n = 47) and a 1.4-/1.7-mm catheter diameter group (n = 76). Clinical and periprocedural outcomes, along with myocardial function assessed by nuclear scintigraphy, were compared.

Results: There were no significant differences in patient characteristics, PCI procedures, or in-hospital outcomes between the two groups. The occurrence of slow coronary flow and final Thrombolysis in Myocardial Infarction (TIMI) flow grade were similar between the two groups. Nuclear scintigraphy showed improvements in systolic function and myocardial salvage in both groups, with greater changes observed in the 0.9 mm group, although baseline differences in myocardial risk may have influenced these results.

Conclusions: The 0.9-mm catheter may achieve myocardial salvage outcomes comparable to larger catheter sizes in STEMI patients undergoing ELCA, though further study is warranted.