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Master Thesis

Imagerie endocoronaire par OCT chez les patients survivant un arrêt cardiaque sans élévation du segment ST à l’électrocardiogramme

Abstract : Ischemic heart disease is the leading cause of out-of-hospital cardiac arrest. In survivors of cardiac arrest, coronary angioplasty is an independent factor of survival and it appears to be as important to select patients with a high probability of underlying acute coronary lesion as it is to optimally identify the culprit lesion. Yet the angiographic aspect alone lacks performance in this task, particularly in non-ST elevation acute coronary syndromes. Among patients without ST-segment elevation on the ECG after restoration of spontaneous circulation, the use of endocoronary OCT imaging could lead to an optimized guided revascularization and avoid inappropriate management. We have performed in survivors of out-of-hospital cardiac arrest without obvious extracardiac cause or ST segment elevation, OCT runs when coronary angiography showed only moderate atheroma (30-70% stenosis). Without considering acute angiographic thrombotic occlusions in 8% of patients, endocoronary OCT imaging in 22 patients with moderate atheroma identified in 11 of them (50%) a culprit lesion subject to an angioplasty. These results underline the need to a better guided revascularization in these most severe patients and OCT appears to be an extremely reliable technique, with no excess risk (no iatrogenic complications in our cohort) and good diagnostic performance. We need randomized controlled studies to assess the prognostic impact of routine use of OCT in this population.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03420550
Contributor : Université Paris Descartes - Scd Connect in order to contact the contributor
Submitted on : Tuesday, November 9, 2021 - 11:24:39 AM
Last modification on : Thursday, December 23, 2021 - 3:08:24 AM

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  • HAL Id : dumas-03420550, version 1

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Pierre Brami. Imagerie endocoronaire par OCT chez les patients survivant un arrêt cardiaque sans élévation du segment ST à l’électrocardiogramme. Médecine humaine et pathologie. 2020. ⟨dumas-03420550⟩

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