[Six-month intravascular ultrasound follow-up of coronary bifurcation lesions treated with rapamycin-eluting stents: technical considerations].
OBJECTIVE
In vitro studies show that stents deform when dilated laterally to access a side branch. This phenomenon may be avoided by use of a kissing balloon at the end of the procedure. However, to date, no in vivo data are available. Our objectives were to investigate the main vessel stent using intravascular ultrasound (IVUS) at six-month follow-up in 55 patients with bifurcation lesions treated using rapamycin-eluting stents and to examine the effect of technical factors.


METHODS
All patients were treated using provisional or T stents. At 6 months, IVUS measurements were made in the main vessel at both proximal and distal ends of the stent, in reference segments, immediately below the side branch ostium, and at the points where the lumen was smallest and where stent expansion was greatest.


RESULTS
The lumen area immediately below the side branch ostium was significantly smaller than that at the point of maximum stent expansion (6.7 [1.8] vs 5.1 [1.3] mm2; P<.05). Underexpansion was not influenced by use of a kissing balloon (stent area immediately under the side branch ostium: 5.5 [0.9] vs 5.6 [1.6] mm2; P=NS) and only one patient experienced restenosis at this point. The lumen areas at the proximal and distal edges of the stent were almost identical in patients who did or did not undergo balloon dilation beyond the ends of the stent.


CONCLUSIONS
Stent underexpansion below the side branch ostium was frequently found following provisional or T stenting of bifurcation lesions. This minor stent deformity was not prevented by use of a kissing balloon nor by any specific side branch treatment and had no significant impact on the restenosis rate.
Pan
Manuel
M
Servicio de Cardiología, Hospital Reina Sofía, Universidad de Córdoba, Córdoba, España. grupo_corpal@arrakis.es
Suárez de Lezo
José
J
Medina
Alfonso
A
Romero
Miguel
M
Delgado
Antonio
A
Segura
José
J
Ojeda
Soledad
S
Pavlovic
Djordje
D
Ariza
Javier
J
Fernández-Dueñas
Jaime
J
Herrador
Juan
J
Ureña
Isabel
I
D003131:Combined Modality Therapy; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000628:therapy*; D016503:Drug Delivery Systems; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D020123:Sirolimus / Q000008:administration & dosage*; D015607:Stents; D013997:Time Factors; D018084:Ultrasonography, Interventional
D007166:Immunosuppressive Agents; D020123:Sirolimus