Title of article :
Stent underexpansion in angiographic guided percutaneous coronary intervention, despite adjunctive balloon post-dilatation, in drug eluting stent era
Author/Authors :
Taherioun، Mehrdad نويسنده Cardiac Rehabilitation Research Centre, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran , , Namazi، Mohammad Hassan نويسنده Associate Professor, Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran , , Safi، Morteza نويسنده , , Saadat، Habibolah نويسنده Professor, Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran , , Vakili، Hossein نويسنده , , Alipour Parsa، Saeed نويسنده Department of Cardiology, Shahid Labbafinejad Medical Center, Shahid Beheshti University, MC, Tehran , , Rajabi-Moghadam، Hasan نويسنده Assistant Professor, Kashan University of Medical Sciences, Kashan, Iran , , Pedari، Shamsedin نويسنده Cardiac Rehabilitation Research Centre, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, 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 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.
