[Direct stent implantation under control of intracoronary ultrasonography. Immediate and late results].
Stents of a new generation have been developed, permitting immediate implantation without predilatation of the lesion site. Intracoronary ultrasound (ICUS) has been found useful in precise evaluation of stent expansion and in improvement of long-term therapeutic outcomes. The purpose of the study was to evaluate the safety and efficacy of direct stent implantation using intracoronary ultrasound. The study comprised 30 patients (8 women and 22 men) aged below 70 years with stable and unstable angina pectoris. ICUS was performed at baseline before making a decision about direct stent implantation and during the procedure to evaluate stent expansion. Direct stenting was performed in 26 patients achieving an angiographically and clinically optimal result (100% efficacy). In four patients direct stenting was abandoned because of massive calcifications in the affected artery detected by ICUS at baseline. During the 9-month follow-up recurrence of anginal pain requiring repeated intervention was observed in 3 patients (11.5%).


CONCLUSIONS
The use of ICUS prior to direct stenting considerably improves the efficacy of the procedure and long-term therapeutic outcomes. Before wide popularisation of direct stenting under ICUS guidance it is necessary to carry out multicentre randomised clinical studies to verify the expected improvement of long-term results as compared with conventional stent implantation with pre-dilatation.
Dudek
D
D
II Klinika Kardiologii Collegium Medicum Uniwersytetu Jagiellońskiego Kraków 31-501, Kopernika 17. mcdudek@cyf-kr.edu.pl
Turek
P
P
Legutko
J
J
Dubiel
J S
JS
D000328:Adult; D000368:Aged; D000787:Angina Pectoris / Q000175:diagnosis* / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019736:Prostheses and Implants; D012086:Reoperation; D015607:Stents; D016896:Treatment Outcome