Application of intravascular ultrasound in coronary atent implantation

摘要

Objetive To determine the evalustion of intravascular ultrasoumd(IVUS) incoronary stent implantation.Bacloground.Until 1992,the success of stent deployment was assessed byangiographic criteris only,but in 1993 the procedure was expanded to includepostprocsdural IVUS imaging.It demonstrated that incomplete apposition of thestent struts to the vessel wall was strill present in 88% of the cases with an optimalangiographic result.Methods.We used mechanical 3.5F 30 MHz monorail intravascularultrasound catheters.Ultrasound criteria for successful stent deployment were(1)symmetry (2)minimal lumen diameter3mm (3)no echo-free spaces betweenthe stent and the vessel and(4)no uncovered dissections.The events,includingacute thrombosis,revascularization,cardiac death and angina pectoris wereobserved at six months of following up.Results.81 cases with stent implantation were studied.Postprocedural IVUSwas performed in 44 cases(Group A)and without IVUS in 37 cases(Group B).The diameter of stents was measured from IVUS imaging and it was 2.72±0.40mm×2.68±0.37 mm.Nine cases(20.5%) needed twice or more to repeat stentdilatation.The pressure of balloon dilatation was 12-15 ATM.A 7.1% reductionin events was observed in the ultrasound group(21.6% event in Group B vs 4.5%in Group A).No acute thrombosis,revascularization,and death happened in theultrasound group.Conclusions.IVUS has an essential role in developing an optimal strategyfor stent deployment.