ARYA Atherosclerosis Journal

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

Document Type : Original Article(s)

Authors

Mehrdad Taherioun 1
Mohammad Hassan Namazi 2
Morteza Safi 2
Habibolah Saadat 3
Hossein Vakili 2
Saeed Alipour-Parsa 4
Hasan Rajabi-Moghadam 5
Shamsedin Pedari 1

1 Cardiac Rehabilitation Research Centre, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

2 Associate Professor, Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

3 Professor, Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

4 Assistant Professor, Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

5 Assistant Professor, Kashan University of Medical Sciences, Kashan, Iran

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.   Keywords: Stent, Percutaneous Coronary Intervention, Ultrasound, Post-dilatation 
ARYA Atherosclerosis Journal
Volume 10, Issue 1 - Serial Number 1
January and February 2014
Pages 13-17

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