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Intravascular ultrasound radiofrequency analysis after optimal coronary stenting with initial quantitative coronary angiography guidance: an ATHEROREMO sub-study
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
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2011 (English)In: EuroIntervention, ISSN 1774-024X, E-ISSN 1969-6213, Vol. 6, no 8, 977-984 p.Article in journal (Refereed) Published
Abstract [en]

AIMS:

To investigate whether the use of intravascular ultrasound virtual histology (IVUS-VH) leads to any improvements in stent deployment, when performed in patients considered to have had an optimal percutaneous coronary intervention (PCI) by quantitative coronary angiography (QCA).

METHODS AND RESULTS:

After optimal PCI result (residual stenosis by QCA<30%), IVUS-VH was performed in 100 patients by protocol, with the option to use the information left to the discretion of the operators. Patients were categorised as: Group1 (n=54), where the IVUS-VH findings were used to evaluate the need for further optimisation of the stent deployment; and Group2 (n=46), where the IVUS-VH was documentary such that the stenting results were considered optimal according to QCA. Optimal stent deployment on IVUS-VH was defined as: normal stent expansion, absence of stent malapposition, complete lesion coverage as indicated by a plaque burden (PB%) between 30-40% and necrotic core confluent to the lumen<10% or PB%<30% at the 5 mm proximal and distal to the stent. The first IVUS-VH in all patients demonstrated the achievement of optimal stent deployment, incomplete lesion coverage, stent under-expansion and stent-edge dissection in 60%, 31%, 20% and 8% of patients, respectively. There was no stent malapposition. In Group 1, 25 patients had optimal stent deployment and did not require further intervention, whilst in 29 patients further intervention was needed (additional stent, n=18; post-dilatation, n=29). Overall optimal stent deployment was finally achieved in 52/54 patients (96%) in Group 1 and 35/46 (76%) of Group 2, p<0.05.

CONCLUSIONS:

IVUS-VH may have a role in facilitating optimal stent implantation and complete lesion coverage.

Place, publisher, year, edition, pages
2011. Vol. 6, no 8, 977-984 p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-198197DOI: 10.4244/EIJV6I8A169PubMedID: 21330246OAI: oai:DiVA.org:uu-198197DiVA: diva2:615408
Available from: 2013-04-10 Created: 2013-04-10 Last updated: 2017-12-06Bibliographically approved

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Sarno, Giovanna

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