Intravascular ultrasound radiofrequency analysis after optimal coronary stenting with initial quantitative coronary angiography guidance: An ATHEROREMO sub-study

Giovanna Sarno, Scot Garg, Josep Gomez-Lara, Hector M. Garcia Garcia, Jurgen Ligthart, Nico Bruining, Yoshinobu Onuma, Karen Witberg, Robert Jan Van Geuns, Sanneke De Boer, Joanna Wykrzykowska, Carl Schultz, Henricus J. Duckers, Evelyn Regar, Peter De Jaegere, Pim De Feyter, Gerrit Anne Van Es, Eric Boersma, Wim Van Der Giessen, Patrick W. Serruys

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Abstract

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.

Original languageEnglish
Pages (from-to)977-984
Number of pages8
JournalEuroIntervention
Volume6
Issue number8
DOIs
Publication statusPublished - 1 Mar 2011
Externally publishedYes

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