No abstract

Quantitative analysis of intracoronary ultrasound (ICUS) studies is performed on a series of tomographic cross-sectional ICUS images acquired during a motorized 0.5 mm/sec catheter pullback. Catheter displacement in the vascular lumen during the cardiac cycle causes an anatomically shuffled ICUS study, which results in a sawtooth-shaped appearance of the coronary segment in longitudinal reconstructed views in quantitative coronary ultrasound software packages. This hampers contour detection and leads to a laborious time-consuming semiquantitative analysis process that may produce inaccurate results. To solve these problems, in the past, online ECG-gated acquisition hardware has been applied. This article describes a novel image-based gating method called Intelligate, which features automatic retrospective selection of end-diastolic frames from videotaped or digitally stored ICUS studies. Our evaluation shows that there are no quantitative differences between analysis results of hardware ECG-gated and Intelligated ICUS studies.

Objective: To assess the effectiveness of routine sirolimus eluting stent (SES) implantation for unselected patients with in-stent restenosis and to provide preliminary information about the angiographic outcome for lesion subgroups and for different in-stent restenosis patterns. Design: Prospective, single centre registry. Setting: Tertiary referral centre. Patients: 44 consecutive patients (53 lesions) without previous brachytherapy who were treated with SES for in-stent restenosis were evaluated. Routine angiographic follow up was obtained at six months and the incidence of major adverse cardiovascular events was evaluated. Results: At baseline, 42% of the lesions were focal, 21% diffuse, 26% proliferative, and 11% total occlusions. Small vessel size (reference diameter ( 2.5 mm) was present in 49%, long lesions (. 20 mm) in 30%, treatment of bypass grafts in 13%, and bifurcation stenting in 18%. At follow up, post-SES restenosis was observed in 14.6%. No restenosis was observed in focal lesions. For more complex lesions, restenosis rates ranged from 20-25%. At the one year follow up, the incidence of death was 0, myocardial infarction 4.7% (n = 2), and target lesion revascularisation 16.3% (n = 7). The target lesion was revascularised because of restenosis in 11.6% (n = 5). Conclusions: Routine SES implantation is highly effective for focal in-stent restenosis and appears to be a promising strategy for more complex patterns of restenosis.

No abstract