Stent boost enhancement compared to intravascular ultrasound in the evaluation of stent expansion in elective percutaneous coronary interventions

IF 1.4 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Egyptian Heart Journal Pub Date : 2018-03-01 DOI:10.1016/j.ehj.2017.09.001

Mohamed Laimoud, Yasser Nassar, Walid Omar, Akram Abdelbarry, Helmy Elghawaby

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引用次数: 12

Abstract

Background

Stent underexpansion is a major risk factor for in-stent restenosis and acute in-stent thrombosis¹Intravascular ultrasound (IVUS) is one of the standards for detection of stent underexpansion (de Feyter et al. 1999; Mintz et al., 2001). StentBoost (SB) enhancement allows an improved angiographic visualization of the stent (Koolen et al., 2005).

Aim of work

Comparison of stent expansion by IVUS and SB enhancement and detection of value of SB to guide dilatation post stent deployment.

Methodology

IVUS, SB enhancement and QCA were done in 30 patients admitted for elective stenting procedures .We compared measurements of mean ±standard deviations of (Max SD, Min SD, Mean SD, stent symmetry index) using IVUS, SB and QCA after stent deployment and after postdilatation whenever necessary to optimize stent deployment. The Stent symmetry index was calculated [(maximum stent diameter minus minimum stent diameter) divided by maximum stent diameter].

Results

The Max SD was (3.45 ± 0.62 vs 3.55 ± 0.56 vs 2.97 ± 0.59) by IVUS vs SB vs QCA respectively. Max SD was significantly higher by IVUS vs QCA (p .009) and between SB vs QCA (p .001) while there was nonsignificant difference between IVUS vs SB (p .53). The Min SD was (2.77 ± 0.53 vs 2.58 ± 0.56 vs 1.88 ± 0.60) by IVUS vs SB vs QCA respectively. Min SD was significantly higher by IVUS vs QCA (p .001) and between SB vs QCA (p .001) while there was nonsignificant difference between IVUS vs SB (p .07). The stent symmetry index was (0.24 ±0.09 vs 0.34 ± 0.09 vs 0.14 ±0.27) by IVUS vs SB vs QCA respectively. It was significantly higher by IVUS vs QCA (p .001) and between SB vs QCA (p .001) while there was nonsignificant difference between IVUS vs SB (p .32). SB was positively correlated with IVUS measurements of Max SD (p < .0001 & r 0.74) and Min SD (p < .0001 & r 0.68). QCA was positively correlated with IVUS measurements of Max SD correlation (p < .0001 & r 0.69) and Min SD (p < .0001 & r 0.63). QCA was positively correlated with SB measurements of Max SD (p < .0001 & r 0.61) and Min SD (p .003 & r 0.49).

Conclusions

StentBoost enhancement has superior correlations for stent expansion measured by IVUS when compared with QCA. SB enhancement improved stent visualization and identification of stent underexpansion to guide stent postdilatation.

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在择期经皮冠状动脉介入治疗中支架扩张的评估中，与血管内超声相比支架增强的效果

背景:支架扩张不足是支架内再狭窄和急性支架内血栓形成的主要危险因素1血管内超声(IVUS)是检测支架扩张不足的标准之一(de Feyter et al. 1999;Mintz et al.， 2001)。StentBoost (SB)增强可以改善支架的血管造影可视化(Koolen等，2005)。工作目的:IVUS与SB增强支架扩张的比较及检测SB对支架置放后扩张的指导价值。方法对30例择期支架置入术患者进行IVUS、SB增强和QCA检查，比较支架置入术后和扩张后优化支架置入术时使用IVUS、SB增强和QCA测量的均数±标准差(Max SD、Min SD、mean SD、支架对称指数)。计算支架对称指数[(最大支架直径减去最小支架直径)除以最大支架直径]。结果IVUS、SB和QCA的最大SD分别为(3.45±0.62 vs 3.55±0.56 vs 2.97±0.59)。IVUS组与QCA组、SB组与QCA组的最大SD均显著高于前者(p .009)，而IVUS组与SB组的差异无统计学意义(p .53)。IVUS、SB和QCA的最小SD分别为(2.77±0.53 vs 2.58±0.56 vs 1.88±0.60)。IVUS组与QCA组、SB组与QCA组的最小SD均显著增高(p .001)，而IVUS组与SB组的差异无统计学意义(p .07)。IVUS、SB、QCA的支架对称指数分别为(0.24±0.09 vs 0.34±0.09 vs 0.14±0.27)。IVUS组与QCA组(p .001)、SB组与QCA组(p .001)差异显著，而IVUS组与SB组(p .32)差异无统计学意义。SB与IVUS测量的Max SD呈正相关(p <。,r 0.74)和最小标准差(p <。,0.68 r)。QCA与IVUS测量的最大SD相关性呈正相关(p <。,r 0.69)和最小标准差(p <。,0.63 r)。QCA与SB测定的最大SD值呈正相关(p <。,r 0.61)和最小标准差(p .003 &0.49 r)。结论与QCA相比，stentboost增强与IVUS测量的支架扩张具有更好的相关性。SB增强改善了支架的可视化和支架扩张不足的识别，以指导支架后扩张。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Egyptian Heart Journal CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

2.10

自引率

0.00%

发文量

审稿时长

9 weeks

期刊介绍： The Egyptian Heart Journal is the official journal of the Egyptian Society of Cardiology. It is an international journal that publishes peer-reviewed articles on all aspects of cardiovascular disease, including original clinical studies and translational investigations. The journal publishes research, review articles, case reports and commentary articles, as well as editorials interpreting and commenting on the research presented. In addition, it provides a forum for the exchange of information on all aspects of cardiovascular medicine, including educational issues.