Abstract 6025: Optimal Stent Deployment. Five Seconds Is Not Enough
Background. The risk of thrombosis which had been well described since the advent of stenting, is currently being re-addressed in the era of drug-eluting stents (DES). Among the predictors of thrombosis risk, there are some factors which may be favourably influenced by the operator. Indeed, the quality of stent deployment is crucial, which has been well demonstrated with IVUS. Inadequate deployment may be associated with numerous parameters. The time factor has never been explored accurately so far.
Objectives. The purpose of this study was to analyse the relationship between the duration of stent balloon inflation and the quality of stent deployment as measured by StentBoost™ in patients with de novo lesions.
Methods. StentBoost™ is a software developed by Philips on the flat panel detector, which averages frames, correcting for motion by using the balloon markers. This creates an enhanced image of the stent with an improved signal-to-noise ratio and allows precise measurements. Pressure of stent deployment was selected according to the reference diameter of the lesion and the diameter/pressure chart of the stent delivery system. A constant pressure was applied for 25 seconds and stent size measured at 5, 15, 25 sec., after deflation and post dilatation when performed. Primary endpoint was optimal stent expansion defined as minimal stent diameter/reference diameter at the lesion site > 80%.
Results. Data were collected prospectively in 77 patients aged 67.8± 12.4 yrs, diabetic (38%), acute coronary syndrome (37 %), in whom 109 stents (length 18.7±6.4 mm; diameter 2.96±0.49 mm) were deployed at a mean pressure of 13.5±2.48 atm. Lesion reference diameter was 3.06±0.58 mm.
Conclusion. Better stent implantation may be achieved by increasing the duration of stent deployment. This may influence the risk of stent thrombosis.