title: Nonrandomized comparison of coronary stenting under intravascular ultrasound guidance of direct stenting without predilation versus conventional predilation with a semi-compliant balloon versus predilation with a new scoring balloon.
abstract: This study was conducted to determine the influence of lesion preparation using the AngioSculpt balloon on final stent expansion. Stent expansion remains an important predictor of restenosis and subacute thrombosis, even in the drug-eluting stent (DES) era. In these patients, the role of different predilation strategies has yet to be established. Two hundred ninety-nine consecutive de novo lesions treated with 1 >2.5-mm DES (Cypher or Taxus) under intravascular ultrasound guidance without postdilation, using 3 implantation strategies, were studied: (1) direct stenting without predilation (n = 145), (2) predilation with a conventional semi-compliant balloon (n = 117), and (3) predilation with the AngioSculpt balloon (n = 37). Stent expansion was defined as the ratio of intravascular ultrasound-measured minimum stent diameter and minimum stent area to the manufacturer's predicted stent diameter and area. These ratios were larger after AngioSculpt predilation, and a greater percentage of stents had final minimum stent areas >5.0 mm(2) (another commonly accepted criterion of adequate DES expansion). Lesion morphology, stent and lesion length, and reference vessel size did not affect DES expansion. In conclusion, in this observational, nonrandomized study, pretreatment with the AngioSculpt balloon enhanced stent expansion and minimized the difference between predicted and achieved stent dimensions.
authors: Cardiovascular Research Foundation and Columbia University Medical Center, New York, New York, USA.
authors: Jose
authors: J
authors: de Ribamar Costa
authors: Gary S
authors: GS
authors: Mintz
authors: Stéphane G
authors: SG
authors: Carlier
authors: Roxana
authors: R
authors: Mehran
authors: Paul
authors: P
authors: Teirstein
authors: Koichi
authors: K
authors: Sano
authors: Xuebo
authors: X
authors: Liu
authors: Joanna
authors: J
authors: Lui
authors: Yingbo
authors: Y
authors: Na
authors: Celia
authors: C
authors: Castellanos
authors: Sinan
authors: S
authors: Biro
authors: Lockeshi
authors: L
authors: Dani
authors: Jason
authors: J
authors: Rinker
authors: Issam
authors: I
authors: Moussa
authors: George
authors: G
authors: Dangas
authors: Alexandra J
authors: AJ
authors: Lansky
authors: Edward M
authors: EM
authors: Kreps
authors: Michael
authors: M
authors: Collins
authors: Gregg W
authors: GW
authors: Stone
authors: Jeffrey W
authors: JW
authors: Moses
authors: Martin B
authors: MB
authors: Leon
mesh_terms: D000368:Aged; D000497:Alloys; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation* / Q000379:methods; D002317:Cardiovascular Agents / Q000627:therapeutic use; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000473:pathology; D019160:Endosonography; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000627:therapeutic use; D011312:Pressure; D011446:Prospective Studies; D020123:Sirolimus / Q000627:therapeutic use; D015607:Stents; D013499:Surface Properties; D018084:Ultrasonography, Interventional
chemical_list: D000497:Alloys; D002317:Cardiovascular Agents; C013616:nitinol; D017239:Paclitaxel; D020123:Sirolimus