ORIGINAL RESEARCH article
Front. Cardiovasc. Med.
Sec. Coronary Artery Disease
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1648233
This article is part of the Research TopicOptimizing Revascularization and Conservative Therapy in Chronic Coronary SyndromeView all 10 articles
Impact of Myocardial Bridge on Lesion Morphology and Clinical Outcomes in Patients Undergoing IVUS-Guided PCI for LAD CTO
Provisionally accepted
- Xiangtan Central Hospital, Xiangtan, China
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This single-center retrospective study included 256 patients with left anterior descending (LAD) chronic total occlusion (CTO) who underwent intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI) between 2016 and 2022. Patients were divided into myocardial bridge (MB) (n = 61) and non-MB (n = 195) groups based on IVUS findings. Lesion morphology, stent strategy, and 2-year clinical outcomes were compared. MB was identified in 23.8% of patients. Compared to the non-MB group, MB patients had significantly shorter CTO length (17.71 mm vs. 21.31 mm, P<0.001), less calcification (29.5% vs. 47.7%, P=0.018), and more proximal lesion distribution (41.0% vs. 20.0%, P=0.001). Despite favorable anatomical features, the MB group showed higher rates of major adverse cardiovascular events (MACE) (19.7% vs. 8.7%, P=0.033) and clinically driven target lesion revascularization (18.0% vs. 6.7%, P=0.016). MB remained an independent predictor of MACE (hazard ratio=2.173; P=0.021) after multivariate adjustment. In LAD CTO lesions, MB is associated with distinctive morphological patterns and worse post-PCI outcomes. The presence of MB warrants cautious procedural planning and may necessitate tailored revascularization strategies to mitigate long-term risks.
Keywords: Myocardial bridge, chronic total occlusion, Left anterior descending artery, Percutaneous Coronary Intervention, Intravascular ultrasound
Received: 16 Jun 2025; Accepted: 07 Jul 2025.
Copyright: © 2025 Wu, Wu, Huang, Liu, Huang and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Lei Wang, Xiangtan Central Hospital, Xiangtan, China
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