Limits...
Optimization of stent deployment by intravascular ultrasound.

Yoon HJ, Hur SH - Korean J. Intern. Med. (2012)

Bottom Line: Since the introduction of the drug-eluting stent (DES), concerns about restenosis have decreased.However, high-risk lesion subsets are being routinely treated with DESs, and the incidence of suboptimal results after stent deployment, such as stent underexpansion, incomplete stent apposition, edge dissection, geographic miss, and the risk of stent thrombosis, have correspondingly increased.Thus, optimization of stent deployment under IVUS guidance may be clinically important.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea.

ABSTRACT
Intravascular ultrasound (IVUS) is a useful diagnostic method that provides valuable information in addition to angiography regarding the coronary vessel lumen, dimensions, plaque burden, and characteristics. The major use of IVUS in coronary intervention is to guide interventional strategies and assess optimal stent deployment. Since the introduction of the drug-eluting stent (DES), concerns about restenosis have decreased. However, high-risk lesion subsets are being routinely treated with DESs, and the incidence of suboptimal results after stent deployment, such as stent underexpansion, incomplete stent apposition, edge dissection, geographic miss, and the risk of stent thrombosis, have correspondingly increased. Thus, optimization of stent deployment under IVUS guidance may be clinically important. In this review, we focus on the potential role of IVUS in stent optimization during percutaneous coronary intervention and its clinical benefits.

Show MeSH

Related in: MedlinePlus

The possible intravascular ultrasound criteria for optimal stent deployment. LM, left main; DES, drug-eluting stent; BMS, bare metal stent.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
getmorefigures.php?uid=PMC3295985&req=5

Figure 5: The possible intravascular ultrasound criteria for optimal stent deployment. LM, left main; DES, drug-eluting stent; BMS, bare metal stent.

Mentions: IVUS can provide direct cross-sectional images as well as longitudinal images of the coronary vessel wall. It has also contributed to our understanding of mechanisms in coronary atherosclerotic plaques and provided real-time information at stented segments after coronary interventions. Possible criteria for optimal stent deployment by IVUS are complete stent apposition to the vessel wall, adequate stent expansion, and full lesion coverage without edge dissection (Fig. 5). Recent data suggest that IVUS-guided PCI may reduce long-term mortality when compared with angiography-guided PCI, particularly after DES implantation; thus, the clinical importance of IVUS-guided PCI raised in the BMS era persists in the DES era. Optimization of stent deployment by IVUS during PCI may be considered as a routine practice in daily PCI, especially for complex lesion intervention.


Optimization of stent deployment by intravascular ultrasound.

Yoon HJ, Hur SH - Korean J. Intern. Med. (2012)

The possible intravascular ultrasound criteria for optimal stent deployment. LM, left main; DES, drug-eluting stent; BMS, bare metal stent.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC3295985&req=5

Figure 5: The possible intravascular ultrasound criteria for optimal stent deployment. LM, left main; DES, drug-eluting stent; BMS, bare metal stent.
Mentions: IVUS can provide direct cross-sectional images as well as longitudinal images of the coronary vessel wall. It has also contributed to our understanding of mechanisms in coronary atherosclerotic plaques and provided real-time information at stented segments after coronary interventions. Possible criteria for optimal stent deployment by IVUS are complete stent apposition to the vessel wall, adequate stent expansion, and full lesion coverage without edge dissection (Fig. 5). Recent data suggest that IVUS-guided PCI may reduce long-term mortality when compared with angiography-guided PCI, particularly after DES implantation; thus, the clinical importance of IVUS-guided PCI raised in the BMS era persists in the DES era. Optimization of stent deployment by IVUS during PCI may be considered as a routine practice in daily PCI, especially for complex lesion intervention.

Bottom Line: Since the introduction of the drug-eluting stent (DES), concerns about restenosis have decreased.However, high-risk lesion subsets are being routinely treated with DESs, and the incidence of suboptimal results after stent deployment, such as stent underexpansion, incomplete stent apposition, edge dissection, geographic miss, and the risk of stent thrombosis, have correspondingly increased.Thus, optimization of stent deployment under IVUS guidance may be clinically important.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea.

ABSTRACT
Intravascular ultrasound (IVUS) is a useful diagnostic method that provides valuable information in addition to angiography regarding the coronary vessel lumen, dimensions, plaque burden, and characteristics. The major use of IVUS in coronary intervention is to guide interventional strategies and assess optimal stent deployment. Since the introduction of the drug-eluting stent (DES), concerns about restenosis have decreased. However, high-risk lesion subsets are being routinely treated with DESs, and the incidence of suboptimal results after stent deployment, such as stent underexpansion, incomplete stent apposition, edge dissection, geographic miss, and the risk of stent thrombosis, have correspondingly increased. Thus, optimization of stent deployment under IVUS guidance may be clinically important. In this review, we focus on the potential role of IVUS in stent optimization during percutaneous coronary intervention and its clinical benefits.

Show MeSH
Related in: MedlinePlus