Document Detail


Intravascular ultrasound assessment of postprocedural incomplete stent apposition.
MedLine Citation:
PMID:  22210583     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: There has been no detailed intravascular ultrasound (IVUS) analysis to evaluate the degree to which stent underexpansion or reference vessel/stent size mismatch contributes to the occurrence of post-procedural incomplete stent apposition (post-ISA).
METHODS: We evaluated 238 lesions treated with everolimus-eluting stents (n = 110) or paclitaxel-eluting stents (n = 128). Reference lumen/stent area ratio was defined as the ratio of lumen area adjacent to the stent edge in the reference segment to stent area at the stent edge or at stent body ISA site.
RESULTS: Post-ISA was observed in 36 of the 238 cases (15%) at the proximal stent edge, 15 of the 238 cases (6%) at the distal stent edge and 14 of the 238 cases (6%) at stent body. Reference lumen/stent area ratio was significantly greater in the ISA group compared with non-ISA in proximal edge (127 ± 20 vs 99 ± 10%; P<.001), and greater reference lumen/stent area ratio (118 ± 18 vs 94 ± 11%; P<.001) and higher presence of calcification (60 vs 29%; P<0.001) were observed in distal edge ISA group compared with non-ISA. At the stent body, presence of calcification was more frequently observed in the ISA compared with the non-ISA group (86 vs 42%; P=.002).
CONCLUSIONS: Post-ISA at the stent edge was significantly associated with vessel/stent mismatch rather than stent underexpansion. IVUS-guided appropriate stent or balloon sizing might be useful to prevent post-ISA and optimize initial stent deployment.
Authors:
Teruyoshi Kume; Katsuhisa Waseda; Junya Ako; Kenji Sakata; Masao Yamasaki; Takao Shimohama; Ichizo Tsujino; Takao Hasegawa; Peter J Fitzgerald; Yasuhiro Honda
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of invasive cardiology     Volume:  24     ISSN:  1557-2501     ISO Abbreviation:  J Invasive Cardiol     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-01-02     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8917477     Medline TA:  J Invasive Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  13-6     Citation Subset:  IM    
Affiliation:
Cardiovascular Medicine, Stanford University, 300 Pasteur Dr, Room H3554, Stanford, CA 94305-5637 USA. crci-cvmed@stanford.edu.
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