Document Type : Original Article
Authors
- SANTOSH KUMAR SINHA 1
- Puneet Aggarwal 2
- Umeshwar Pandey 3
- Najeen Ullah Sofi 4
- Mohit Sachan 5
- Mahmodullah Razi 4
- Awadhesh Kumar Sharma 5
- Mukesh Jitendra Jha 6
- Kumar Himanshu 7
- Praveen Shukla 7
- Rakesh Kumar Varma 7
1 Professor. Department of Cardiology, LPS Institute of Cardiology G.S.V.M. Medical College, Kanpur, Uttar Pradesh, INDIA 208002
2 Department of Cardiology, RML and ABMS Institute of Cardiology New Delhi, INDIA 208002
3 Dept of , Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh, INDIA
4 Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh, INDIA
5 Department of Cardiology, LPS Institute of Cardiology G.S.V.M. Medical College, Kanpur, Uttar Pradesh, INDIA 208002
6 Assistant Proff, LPS Institute of Cardiology G.S.V.M. Medical College, Kanpur, Uttar Pradesh, INDIA 208002
7 Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh, INDIA.
Abstract
Background- Intravascular ultrasound (IVUS) guided percutaneous coronary intervention (PCI) is useful in stent optimization. Outcomes of ultrathin, Supralimus Tetriflex stent (Sajahanand Medical Technologies Pvt. Ltd. India) using IVUS was evaluated among patients with short (≤ 20mm) vs. long lesion (≥ 20mm).
Method- 207 patients underwent PCI and IVUS was performed post deployment. Primary outcome was optimal stent deployment defined as (a) mean surface area (MSA) >5.0 mm2; (b) plaque burden <50%; (3) complete apposition, and (3) no edge dissection. Secondary outcome were target lesion failure (TLF)- composite of cardiac death, target vessel myocardial infarction (TVMI), and target lesion revascularization (TLR), stent thrombosis, and major adverse cardiovascular events (MACE; composite of death, MI, stent thrombosis, and repeat revascularisation).
Result- Sub-optimal deployment was significantly more among patients with longer lesion (30.1% vs. 23.3%; p=0.03) because of higher mal-apposition (17.3% vs. 10.6%) and MSA<5mm2 (9.6% vs. 7.7%). Following post dilatation, suboptimal deployment was observed in 7.6% and 5.8% respectively. Residual plaque burden were 4.5% and 5.7% respectively. MSA in both groups were 6.3 mm2 and 6.5mm2. Minimum and mean stent expansion were (82.1% vs. 81.7%) and (106.3% vs. 109.8%) respectively with no significant difference. TLF and ST were observed in (0.9% vs. 0.9%) and (2.9% vs. 3.8%) patients with no significant difference. However, MACE was significantly higher (10.5% vs. 8.7%; p=0.05) among patients with longer lesion.
Conclusion- Supralimus Tetriflex stent has very good optimal deployment based on angiogram and becomes better with IVUS imaging, making it safe among long lesions (≥ 20mm).
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