Stent Underexpansion in Angiographic Guided Percutaneous Coronary Intervention, Despite Adjunctive Balloon Post-dilatation, in Drug Eluting Stent Era

Overview

Journal ARYA Atheroscler

Date 2014 Jun 26

PMID 24963308

Citations 2

Authors

Mehrdad Taherioun

Mohammad Hassan Namazi

Morteza Safi

Habibolah Saadat

Hossein Vakili

Saeed Alipour-Parsa

Hasan Rajabi-Moghadam

Shamsedin Pedari

Affiliations

Soon will be listed here.

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 non-compliant 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.

Citing Articles

Triple-Guidewire Technique for Treating Stent Underexpansion in Severely Calcified Coronary Artery Lesions.

Gedela M, Li S, Desai C, Stys T, Stys A Tex Heart Inst J. 2020; 47(2):155-159.

PMID: 32603468 PMC: 7328083. DOI: 10.14503/THIJ-18-6622.

Aggressive plaque modification with rotational atherectomy and cutting balloon for optimal stent expansion in calcified lesions.

Tang Z, Bai J, Su S, Lee P, Peng L, Zhang T J Geriatr Cardiol. 2017; 13(12):984-991.

PMID: 28321242 PMC: 5351830. DOI: 10.11909/j.issn.1671-5411.2016.12.007.

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