Document Detail


Intravascular ultrasonic predictors of angiographic restenosis after long coronary stenting.
MedLine Citation:
PMID:  10728947     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The intravascular ultrasound (IVUS) criteria for stent optimization have not been determined in stenting long lesions. We evaluated the predictors of angiographic restenosis and compared it with stent lumen cross-sectional area (CSA) and stent length between short (stent length <20 mm) and long (> or =20 mm) coronary stenting. IVUS-guided coronary stenting was successfully performed in 285 consecutive patients with 304 native coronary lesions. Six-month follow-up angiogram was performed in 236 patients (82.8%) with 246 lesions (80.9%). Results were evaluated using conventional (clinical, angiographic, and IVUS) methods. The overall angiographic restenosis rate was 22.8% (56 of 246 lesions) (short stent 17.6% vs. long stent 32.2%, p = 0.009). Using multivariate logistic regression analysis, the independent predictors of angiographic restenosis were the IVUS stent lumen CSA (odds ratio 1.51, 95% confidence intervals 1.18 to 1.92, p = 0.001) and stent length (odds ratio 0.95, 95% confidence intervals 0.91 to 1.00, p = 0.039). The angiographic restenosis rate was 54.8% for stent lumen CSA of <5.0 mm2 (short stent 37.5% vs. long stent 73.3%, p = 0.049), 27.4% for CSA between 5.0 and 7.0 mm2 (short stent 24.1% vs. long stent 31.7%, p = 0.409), 10.5% for CSA between 7.0 and 9.0 mm2 (short stent 10.0% vs. long stent 12.5%, p = 0.772), and 11.4% for stent lumen CSA of > or =9.0 mm2 (short stent 10.4% vs. long stent 13.3%, p = 0.767) (p = 0.001). Compared with short coronary stenting, long coronary stenting is effective treatment modality to cover long lesions with comparable long-term clinical outcomes in cases of stent lumen CSA of > or =7.0 mm2. Regardless of the stent length, the most important factor determining angiographic restenosis was the IVUS stent lumen CSA in relatively large coronary artery lesions.
Authors:
M K Hong; S W Park; G S Mintz; N H Lee; C W Lee; J J Kim; S J Park
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The American journal of cardiology     Volume:  85     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2000 Feb 
Date Detail:
Created Date:  2000-03-31     Completed Date:  2000-03-31     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:  441-5     Citation Subset:  AIM; IM    
Affiliation:
Department of Internal Medicine, College of Medicine, University of Ulsan, Cardiovascular Center, Asan Medical Center, Seoul, Korea.
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MeSH Terms
Descriptor/Qualifier:
Blood Vessel Prosthesis Implantation*
Coronary Angiography
Coronary Disease / radiography,  surgery*,  ultrasonography
Coronary Vessels / ultrasonography*
Female
Graft Occlusion, Vascular / radiography,  ultrasonography*
Humans
Male
Middle Aged
Odds Ratio
Predictive Value of Tests
Stents*
Ultrasonography, Interventional*

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


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