Abstract 4909: Usefulness of Stent Boost Enhancement for Stent Expansion During Coronary Angioplasty in Daily Practice
Background: Adequate stent expansion plays a major part in the occurrence of thrombosis and restenosis in patients undergoing PCI. X-ray assessment of correct stent deployment can be difficult due to poor visualization of the stent structure and to rapid stent movement. The gold standard evaluation method is IVUS, but routine use is costly and time-consuming. Stent boost is a new technique improving fluoroscopy-based assessment of stent expansion. The purpose of the study was to assess the usefulness and impact of stent boost in routine practice.
Methods: StentBoost ™ (SB™) is a software developed by Philips. A short digital cine run is acquired with a deflated balloon in place. The software averages selected frames (centred on the stent) and creates an enhanced image improving signal-to-noise ratio. A total of 230 consecutive patients were prospectively included, (mean age : 6711years) and 278 coronary stents (mean size 18.85±6.5 2.96±0.48 mm) analyzed. Stent visibility was assessed using both standard angio and SB™ and graded from 1 to 4 (1= poor, 2= average, 3= good, 4= excellent). The need for post dilatation was evaluated (0= well deployed stent, post dilatation not required; 1= inadequately deployed stent, post dilatation not performed; 2 = inadequately deployed stent, post dilatation performed). The usefulness of SB™ compared with conventional angio images was graded: 0= not needed in the presence of sufficient angio data, 1= SB™ useful compared to angio data.
Results: Visualization of adequate stent expansion was improved by the use of the stent boost system. Angiographic stent visibility was: 1= 26%, 2= 46%, 3= 26, 4= 2%; with a mean of 2.03±0.76. SB ™ visibility was 1= 11%; 2= 20%; 3= 54%,4= 15%with a mean of 2.76±0.94. The use of SB™ after each stent implantation was deemed useful in 72% of cases. Post dilation after stent implantation was performed in 31% of cases.
Conclusion: Post angioplasty assessment of adequate stent expansion, by means of the stent boost system was deemed useful in a large majority of cases. This user-friendly system does not increase procedure duration and may decrease the risk of stent thrombosis.