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Short-Term Progression of Multiterritorial Subclinical Atherosclerosis Intravascular Ultrasound Guidance Is Associated With Better Outcome in Patients Undergoing Unprotected Left Main Coronary Artery Stenting Compared With Angiography Guidance Alone Early Surgery or Conservative Care for Asymptomatic Aortic Stenosis Impact of Positive and Negative Lesion Site Remodeling on Clinical Outcomes : Insights From PROSPECT Colchicine Reduces Cardiovascular Events in Chronic Coronary Disease Predictors of high residual gradient after transcatheter aortic valve replacement in bicuspid aortic valve stenosis 2019 Guidelines on Diabetes, Pre-Diabetes and Cardiovascular Diseases developed in collaboration with the EASD ESC Clinical Practice Guidelines Exercise Intolerance in Patients With Heart Failure: JACC State-of-the-Art Review Prognostic value of coronary artery calcium screening in subjects with and without diabetes Heart Failure With Recovered Left Ventricular Ejection Fraction: JACC Scientific Expert Panel

Original Research2006 Jun;27(11):1305-10.

JOURNAL:Eur Heart J. Article Link

Intravascular ultrasound predictors of angiographic restenosis after sirolimus-eluting stent implantation

Hong MK, Mintz GS, Lee CW et al. Keywords: post-procedural final minimum stent area; IVUS; sirolimus-eluting stent; angiographic restenosis; stent length

ABSTRACT

 

AIMS - In many countries, drug-eluting stent implantation is the dominant interventional strategy. We evaluated the clinical, angiographic, procedural, and intravascular ultrasound (IVUS) predictors of angiographic restenosis after sirolimus-eluting stent (SES) implantation.

 

METHODS AND RESULTS - SES implantation was successfully performed in 550 patients with 670 native coronary lesions. Six-month follow-up angiography was performed in 449 patients (81.6%) with 543 lesions (81.1%). Clinical, angiographic, procedural, and IVUS predictors of restenosis were determined. Using multivariable logistic regression analysis, the only independent predictors of angiographic restenosis were post-procedural final minimum stent area by IVUS [odds ratio (OR)=0.586, 95% confidence interval (CI) 0.387-0.888, P=0.012] and IVUS-measured stent length (OR=1.029, 95% CI 1.002-1.056, P=0.035). Final minimum stent area by IVUS and IVUS-measured stent length that best separated restenosis from non-restenosis were 5.5 mm2 and 40 mm, respectively. Lesions with final minimum stent area<5.5 mm2 and stent length>40 mm had the highest rate of angiographic restenosis [17.7% (11/62)], P<0.001 compared with other groups.

 

CONCLUSION - Independent predictors of angiographic restenosis after SES implantation were post-procedural final minimum stent area by IVUS and IVUS-measured stent length. The angiographic restenosis rate was highest in lesions with stent area<5.5 mm2 and stent length>40 mm.