Evaluation of novel ultrathin, biodegradable polymer tetriflex (sirolimus-eluting stent) optimization using intravascular ultrasound (IVUS) in short coronary lesion (≤ 20mm) vs. long coronary lesion (≥ 20mm): Tetriflex IVUS study.

Abstract

Background: Intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI) is useful for stent optimization. Outcomes of the ultrathin Supralimus Tetriflex stent (Sahajanand Medical Technologies Pvt. Ltd., India) using IVUS were evaluated among patients with short (≤ 20 mm) versus long lesions (≥ 20 mm).

Methods: A total of 207 patients underwent PCI, and IVUS was performed post-deployment. The primary outcome was optimal stent deployment, defined as (a) mean surface area (MSA) >5.0 mm²; (b) plaque burden <50%; (c) complete apposition; and (d) no edge dissection. Secondary outcomes were target lesion failure (TLF)-a composite of cardiac death, target vessel myocardial infarction (TVMI), and target lesion revascularization (TLR)-stent thrombosis, and major adverse cardiovascular events (MACE; a composite of death, MI, stent thrombosis, and repeat revascularization).

Results: Suboptimal deployment was significantly more frequent among patients with longer lesions (30.1% vs. 23.3%; p=0.03) due to higher rates of malapposition (17.3% vs. 10.6%) and MSA <5 mm² (9.6% vs. 7.7%). Following post-dilatation, suboptimal deployment was observed in 7.6% and 5.8% of patients, respectively. Residual plaque burden was 4.5% and 5.7%, respectively. The MSA in both groups was 6.3 mm² and 6.5 mm². Minimum and mean stent expansions were 82.1% versus 81.7% and 106.3% versus 109.8%, respectively, with no significant differences. TLF and stent thrombosis were observed in 0.9% versus 0.9% and 2.9% versus 3.8% of patients, respectively, with no significant differences. However, MACE was significantly higher (10.5% vs. 8.7%; p=0.05) among patients with longer lesions.

Conclusion: Supralimus Tetriflex stent has very good optimal deployment based on angiogram and becomes better with IVUS imaging, making it safe among long lesions (≥ 20mm).