title: Quantitative changes in reference segments during IVUS-guided stent implantation: impact on the criteria for optimal stent expansion.
abstract: Intravascular ultrasound is an established method to optimize stent implantation. Stent expansion is estimated from the relation between minimal in-stent cross-sectional area and reference lumen area. We analyzed the periprocedural lumen increment in the reference segments and its impact on intravascular ultrasound (IVUS) criteria for optimized stenting. Seventy-five consecutive patients were studied with a 2.9 Fr, 30-MHz system and motorized pullback (0.5 mm/sec). Lumen area was measured by planimetry; absolute and relative differences in area (delta area) were calculated. Lumen area increment for reference segments proximal and distal to the stent was 6.4% +/- 10.3% and 6.1% +/- 10.8%; 49/75 patients fulfilled all IVUS criteria for optimal stent expansion at the final IVUS assessment, and 10/75 patients met all the IVUS criteria in relation to the first measurement of reference lumen area, but not in relation to the final measurement of reference lumen area. During high-pressure dilatation within the stent, reference lumen increment is visible. If reference lumen planimetry is not repeated after additional high-pressure balloon inflation, the final relative stent expansion may be overestimated.
authors.affiliation: Medizinische Klinik, Klinikum Innenstadt, University of Munich, Germany.
authors.forename: E
authors.initials: E
authors.lastname: Regar
authors.forename: V
authors.initials: V
authors.lastname: Klauss
authors.forename: F
authors.initials: F
authors.lastname: Werner
authors.forename: K H
authors.initials: KH
authors.lastname: Henneke
authors.forename: J
authors.initials: J
authors.lastname: Rieber
authors.forename: A
authors.initials: A
authors.lastname: König
authors.forename: K
authors.initials: K
authors.lastname: Theisen
authors.forename: H
authors.initials: H
authors.lastname: Mudra
mesh_terms: D015906:Angioplasty, Balloon, Coronary; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000628:therapy; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D006801:Humans; D015607:Stents; D018084:Ultrasonography, Interventional