title: Intravascular ultrasound radiofrequency analysis after optimal coronary stenting with initial quantitative coronary angiography guidance: an ATHEROREMO sub-study.
abstract: OBJECTIVE
  To investigate whether the use of intravascular ultrasound virtual histology (IVUS-VH) leads to any improvements in stent deployment, when performed in patients considered to have had an optimal percutaneous coronary intervention (PCI) by quantitative coronary angiography (QCA).
  
  
  RESULTS
  After optimal PCI result (residual stenosis by QCA<30%), IVUS-VH was performed in 100 patients by protocol, with the option to use the information left to the discretion of the operators. Patients were categorised as: Group1 (n=54), where the IVUS-VH findings were used to evaluate the need for further optimisation of the stent deployment; and Group2 (n=46), where the IVUS-VH was documentary such that the stenting results were considered optimal according to QCA. Optimal stent deployment on IVUS-VH was defined as: normal stent expansion, absence of stent malapposition, complete lesion coverage as indicated by a plaque burden (PB%) between 30-40% and necrotic core confluent to the lumen<10% or PB%<30% at the 5 mm proximal and distal to the stent. The first IVUS-VH in all patients demonstrated the achievement of optimal stent deployment, incomplete lesion coverage, stent under-expansion and stent-edge dissection in 60%, 31%, 20% and 8% of patients, respectively. There was no stent malapposition. In Group 1, 25 patients had optimal stent deployment and did not require further intervention, whilst in 29 patients further intervention was needed (additional stent, n=18; post-dilatation, n=29). Overall optimal stent deployment was finally achieved in 52/54 patients (96%) in Group 1 and 35/46 (76%) of Group 2, p<0.05.
  
  
  CONCLUSIONS
  IVUS-VH may have a role in facilitating optimal stent implantation and complete lesion coverage.
authors.affiliation: Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Sarno
authors.forename: Scot
authors.initials: S
authors.lastname: Garg
authors.forename: Josep
authors.initials: J
authors.lastname: Gomez-Lara
authors.forename: Hector M
authors.initials: HM
authors.lastname: Garcia Garcia
authors.forename: Jurgen
authors.initials: J
authors.lastname: Ligthart
authors.forename: Nico
authors.initials: N
authors.lastname: Bruining
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Onuma
authors.forename: Karen
authors.initials: K
authors.lastname: Witberg
authors.forename: Robert-Jan
authors.initials: RJ
authors.lastname: van Geuns
authors.forename: Sanneke
authors.initials: S
authors.lastname: de Boer
authors.forename: Joanna
authors.initials: J
authors.lastname: Wykrzykowska
authors.forename: Carl
authors.initials: C
authors.lastname: Schultz
authors.forename: Henricus J
authors.initials: HJ
authors.lastname: Duckers
authors.forename: Evelyn
authors.initials: E
authors.lastname: Regar
authors.forename: Peter
authors.initials: P
authors.lastname: de Jaegere
authors.forename: Pim
authors.initials: P
authors.lastname: de Feyter
authors.forename: Gerrit Anne
authors.initials: GA
authors.lastname: van Es
authors.forename: Eric
authors.initials: E
authors.lastname: Boersma
authors.forename: Wim
authors.initials: W
authors.lastname: van der Giessen
authors.forename: Patrick W
authors.initials: PW
authors.lastname: Serruys
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods / Q000592:standards*; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000628:therapy; D003331:Coronary Vessels / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D015607:Stents / Q000592:standards*; D018084:Ultrasonography, Interventional / Q000379:methods / Q000592:standards*