Document Detail


Coronary wallstents show significant late, postprocedural expansion despite implantation with adjunct high-pressure balloon inflations.
MedLine Citation:
PMID:  9678279     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Adjunct high-pressure balloon inflations following the delivery of oversized self-expandable Wallstents may affect their implied late, postprocedural self-expansion. Consequently, we examined 15 "Magic" Wallstents, which were implanted following a strategy of stent oversizing and subsequent adjunct high-pressure balloon inflations (16 +/- 2 atm; all > or = 12 atm). The excellent radiographic visibility of this stent permitted reliable quantitative coronary angiographic measurement of both lumen and stent dimensions (before and after stenting, and at follow-up). At follow-up, extent and distribution of in-stent neointimal proliferation were evaluated with volumetric intravascular ultrasound. Between postintervention and follow-up examination, mean stent diameter increased from 3.7 +/- 0.4 to 4.2 +/- 0.4 mm (p <0.0001); there was no significant difference in late stent expansion between proximal, mid-, and distal stent subsegments. Late stent expansion showed a significant (reverse) relation to maximum balloon size (r = -0.56, p <0.04), but not with follow-up lumen size or late lumen loss. On average, 52 +/- 18% of the stent was filled with neointimal ingrowth; neointimal volume/cm stent length was 64 +/- 22 mm3. Both late stent expansion (r = 0.36, p <0.02) and maximum balloon pressure (r = 0.41, p <0.001) were related to neointimal volume/cm stent but not to follow-up lumen size. Thus, despite high-pressure implantation, Wallstents showed significant late self-expansion, which resulted in larger stent dimensions at follow-up that assisted in accommodating in-stent neointimal proliferation. Conversely, late stent expansion had a significant relation to the extent of in-stent neointimal ingrowth. Beneficial and disadvantageous effects of the late stent expansion appear to be balanced, because a relation to late lumen loss or follow-up lumen dimensions was not found to be present.
Authors:
C von Birgelen; S G Airiian; P J de Feyter; D P Foley; W J van der Giessen; P W Serruys
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of cardiology     Volume:  82     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1998 Jul 
Date Detail:
Created Date:  1998-08-12     Completed Date:  1998-08-12     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  129-34     Citation Subset:  AIM; IM    
Affiliation:
Thoraxcenter, University Hospital Rotterdam-Dijkzigt and Erasmus University Rotterdam, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Balloon / methods*
Confounding Factors (Epidemiology)
Coronary Angiography / methods
Coronary Disease / therapy*,  ultrasonography
Female
Humans
Male
Middle Aged
Stents*
Treatment Outcome
Ultrasonography, Interventional

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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