Abstract 11326: Stent Expansion After Additional Non-Compliant Balloon High-Pressure Inflation in Patients With Drug-Eluting Stent Underexpansion: An Intravascular Ultrasound Study
Background: Stent underexpansion is one of the causes of drug-eluting stent (DES) failure (restenosis and thrombosis).
Methods: We used intravascular ultrasound (IVUS) to evaluate stent expansion in patients with DES underexpansion (minimal stent area [MSA] <5mm2) in 52 lesions (50 pts) that had IVUS analysis before and after DES implantation. Additional non-compliant (NC) balloon high-pressure inflation (>18atm) was used, and post-NC balloon IVUS was repeated in all pts. Negative remodeling was defined as a remodeling index (lesion/reference arterial area) <0.95. % stent expansion was defined as minimal stent area(MSA)/average reference lumen area.
Results: Pt age was 62±10.4 yrs, and 19% were diabetic. Pre-DES the distal reference lumen area was 4.78±1.34mm2, minimal lumen area was 2.53±0.53mm2, and remodeling index was 0.98±0.08. MSA was increased after additional NC balloon inflation (p=0.004), and % stent expansion was improved (p=0.002); however, stent underexpansion still persisted as 56% (29/52) had a MSA <90% of distal reference lumen and in 62% (32/52) the MSA was still <5mm2.
Conclusion: IVUS showed that DES underexpansion can be an unsolved problem even after additional high pressure NC balloon inflation.
- © 2010 by American Heart Association, Inc.