title: [Expansion of the Multilink-Tristar stent after direct implantation and predilatation: comparison of clinical, angiography and intravascular ultrasound parameters].
abstract: Coronary stenting has become the primary therapeutic option for many coronary lesions. As opposed to conventional stenting the advantages of direct stenting are a reduction of procedural time, radiation exposure and costs. However, data about the incidence of in-stent restenosis are so far not available. It was the aim of this prospective study to compare the expansion of the Multilink stent after direct stenting and predilatation by quantitative coronary angiography (QCA) and intravascular ultrasound (IVUS). Between January 2000 and June 2001, 82 patients were assigned to direct stenting (46 lesions) or predilatation (40 lesions) in lesions of coronary arteries > 3 mm. The procedural success rate was 92% in patients undergoing direct stenting. The baseline clinical characteristics were similar in both groups. The comparison of the angiographic data shows that direct stenting was performed in lesions with a lower degree of stenosis (71 +/- 12% vs 79 +/- 11%, p = 0.01) and that significantly shorter stents were used (14.4 +/- 3.0 vs 17.8 +/- 4.1 mm, p = 0.0007). The mean stenosis length was not significantly different in either group (10.5 +/- 3.4 vs 11.7 +/- 4.3 mm, n.s.). The QCA data after stent implantation show no differences of either implantation technique. Stent expansion was assessed by IVUS estimation of the proximal, distal and minimal in stent area. The minimal in-stent area (9.53 +/- 3.23, mm2 vs 8.65 +/- 1.96 mm2, n.s.) and the stent symmetry index (0.88 vs 0.88 n.s.) were not different in either patient group. These results indicate that in this subset of selected coronary lesions > 3 mm, elective stent implantation with and without predilatation effectively can achieve comparable stent expansion as assessed by QCA and IVUS. In comparison to conventional stent implantation stents, which were implanted without predilatation, were significantly shorter to cover the same lesion length.
authors.affiliation: I. Medizinische Klinik Universitätsklinikum Mannheim Fakultät für Klinische Medizin der Universität Heidelberg Theodor-Kutzer-Ufer 1-3 68161 Mannheim, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Süselbeck
authors.forename: A
authors.initials: A
authors.lastname: Latsch
authors.forename: M
authors.initials: M
authors.lastname: von Fürstenberg
authors.forename: T
authors.initials: T
authors.lastname: Pörner
authors.forename: S
authors.initials: S
authors.lastname: Pfleger
authors.forename: C
authors.initials: C
authors.lastname: Wolpert
authors.forename: M
authors.initials: M
authors.lastname: Borggrefe
authors.forename: K K
authors.initials: KK
authors.lastname: Haase
mesh_terms: D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation*; D017023:Coronary Angiography; D003327:Coronary Disease / Q000175:diagnosis / Q000628:therapy*; D023903:Coronary Restenosis / Q000175:diagnosis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011474:Prosthesis Design; D012680:Sensitivity and Specificity; D015607:Stents; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional