Stent underexpansion in angiographic guided percutaneous coronary intervention, despite adjunctive balloon post-dilatation, in drug eluting stent era

Taherioun, M. and Namazi, M.H. and Safi, M. and Saadat, H. and Vakili, H. and Alipur-Parsa, S. and Rajabi-Moghadam, H. and Pedari, S. (2014) Stent underexpansion in angiographic guided percutaneous coronary intervention, despite adjunctive balloon post-dilatation, in drug eluting stent era. ARYA Atherosclerosis, 10 (1). pp. 13-17.

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Abstract

BACKGROUND: Stent underexpansion is the most powerful predictor of long-term stent patency and clinical outcome. The purpose of this study was to evaluate the incidence and predictors of stent underexpansion despite adjunctive post-dilatation with non-compliant balloon. METHODS: After elective coronary stent implantation and adjunctive post-dilatation with noncompliant balloon and optimal angiographic result confirmed by the operator, intravascular ultrasound (IVUS) was performed for all the treated lesions. If the treated lesions fulfilled the IVUS criteria, they are considered as the optimal stent group; if not, they are considered as the suboptimal group. RESULTS: From 50 patients enrolled in this study 39 (78) had optimal stent deployment and 11 (22) had suboptimal stent deployment. In the suboptimal group 7 (14) had underexpansion, 2 (4) malposition, and 2 (4) had asymmetry. There were no stent edge dissections detected by IVUS. We did not find any correlation between lesion calcification, ostial lesions, stent length, and stent underexpansion. Stent diameter � 2.75 mm had a strong correlation with stent underexpansion. CONCLUSION: Despite adjunctive post-dilatation with noncompliant balloon, using a relatively small stent diameter was a strong predictor for underexpansion. IVUS guided percutaneous coronary intervention (PCI) may be considered for drug eluting stent (DES) implantation in relatively small vessels.

Item Type: Article
Additional Information: cited By 0
Uncontrolled Keywords: acetylsalicylic acid; clopidogrel; heparin, acute heart infarction; adult; article; balloon; balloon dilatation; clinical article; diabetes mellitus; drug eluting stent; female; heart ejection fraction; human; hyperlipidemia; hypertension; intravascular ultrasound; intravascular ultrasound system; loading drug dose; male; medical device complication; percutaneous coronary intervention; physical parameters; prevalence; smoking; stent asymmetry; stent diameter; stent edge dissection; stent malapposition; stent underexpansion
Subjects: Medicine
Divisions: Faculty of Medicine > Clinical Sciences > Department of Cardiology
Depositing User: editor . 2
Date Deposited: 05 Mar 2017 05:17
Last Modified: 05 Mar 2017 05:17
URI: http://eprints.kaums.ac.ir/id/eprint/520

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