Assessment of optimum stent deployment by stent boost imaging: comparison with intravascular ultrasound

Tanaka, Nobuhiro; Pijls, Nico H.J.; Koolen, Jacques; Botman, Kees Joost; Michels, H. R.; Brueren, B R G; Peels, Kathinka; Shindo, Naohisa; Yamashita, Jun; Yamashina, Akira

doi:10.1007/s00380-011-0202-9

Cited by 28 publications

(19 citation statements)

References 10 publications

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“…Our results indicate that this technique can provide valuable information through several stages of the procedure (balloon and stent positioning, need for post-dilatation) and avoid periprocedural complications, moreover, this information was very important for ostial lesions. Tanaka, et al conducted a study in which they concluded that SB image quantification exhibited rather poor sensitivity (33%), 26) on the contrary, our results showed good sensitivity (80%). The different types of lesions may be one of the important reasons.…”

Section: Discussioncontrasting

confidence: 43%

Stent Boost Subtract Imaging for the Assessment of Optimal Stent Deployment in Coronary Ostial Lesion Intervention

et al. 2015

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SummaryPercutaneous coronary intervention (PCI) of ostial lesions is complex and is technically very demanding. Intravascular ultrasound (IVUS) is considered the gold standard method to guide PCI but has several limitations. Stent boost subtract (SBS) imaging is an enhancement of the radiologic edge of the stent by digital management of regular X-ray images. The purpose of this study was to determine the availability of stent enhancement with SBS during ostial PCI by comparison with IVUS.We investigated SBS and IVUS after stent implantation in 58 ostial lesions in 55 patients. SBS and IVUS were performed in all patients to obtain improved stent location and to detect optimal release and deployment. We defined the SBS and IVUS criteria for accuracy of stent location and adequate stent deployment. IVUS findings showed that stent location was generally good. The location was accurate in 48 (82.8%) and inadequate stent deployment was observed in 10 of 58 (17.2%). Eight SBS images showed inadequate stent expansion. SBS predicted inadequate findings of IVUS with 100% specificity and 80% sensitivity, while a significant positive correlation was observed between SBS-MSA and MSA by IVUS with a regression coefficient of 0.95.Imaging techniques have a primary role during ostial PCI. SBS is a simple and quick method that offers several advantages, enabling improved stent location, adequate stent expansion, and optimal apposition of the struts to the wall. SBS imaging could be conventionally used during ostial PCI, especially in centers where IVUS is not used routinely. (Int Heart J 2015; 56: 37-42) Key words: Percutaneous coronary intervention, Apposition, Stent location, Stent expansion P ercutaneous coronary intervention (PCI) of coronary ostial lesions is technically difficult leading to higher rates of adverse cardiac events compared with PCI of non-ostial coronary lesions.1-4) The challenges of PCI of an ostial lesion may depend not only upon the lesion location (ie, aorto-ostial versus non-aorto-ostial), but also on the plaque burden and lesion morphology. Ostial lesions are less compliant compared with non-ostial lesions due to increased fibrosis, calcification, and muscular/elastic tissue, the latter of which is especially evident in aorto-ostial disease.5) Complete stent coverage of ostial lesions can be problematic, with inaccurate stent placement leading to higher rates of restenosis. 6) Compared with coronary angiography, intravascular ultrasound (IVUS) allows for a more detailed assessment of coronary anatomy, including plaque characteristics and morphology, vessel size, and precise localization of the true ostium.7) The only reliable way to exclude insufficient stent deployment with certainty is IVUS.8-10) However, in daily practice, this technique is not used routinely because it is expensive, time-consuming, and there is a learning curve (requiring trained operators and laboratory staff).11) Moreover, it is difficult to obtain an accurate location of the stent before the stent is released. Stent boost sub...

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Section: Discussioncontrasting

confidence: 43%

Stent Boost Subtract Imaging for the Assessment of Optimal Stent Deployment in Coronary Ostial Lesion Intervention

et al. 2015

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“…The WSS magnitude of 1.9 in the non-stented model at θ = 270° around the aneurysm neck in the stented model of bifurcation than that in the stented model of bifurcation. In-stent restenosis is a common phenomenon with bare metal stent in the early stage after deployment [35] . Moreover, the existence of aneurysm might affect the pulsatile energy loss along the major aorta [36] , and a high WSS may be associated with an intimal tear in patients with overt aortic dissection [37] .…”

Section: Discussionmentioning

confidence: 99%

Suppression of Wall Shear Stress inside Intracranial Aneurysms by Simple Stents

et al. 2018

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The effect of a simple bare-metal stent on suppression of wall shear stress inside a spherical intracranial aneurysm model was experimentally examined by two dimensional particle image velocimetry in vitro. The flow model simulated an intracranial aneurysm induced both at the side wall and at the apex of bifurcation in the cerebral arteries. In order to assess the simple bare metal stent characteristics, the variation of wall shear stress was examined using both stented and non-stented models. The flow behavior inside the stented aneurysm was not smooth and wall shear stress was significantly smaller inside the aneurysm. For both models, the maximum and the temporal and spatial averaged wall shear stress in the stented model is reduced by at least 50 % smaller than those in the non-stented models. Stent deployment effectively suppresses the temporal and spatial variations, and the magnitude of wall shear stress. Consequently, even simple stent might be an effective treatment to retard the progress of cerebral aneurysms.

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“…Thus, longitudinal stent deformation might be underestimated when using angiography alone. It has been reported that stent boost imaging could predict IVUS findings of inadequate stent implantation with high specificity . Stent boost imaging might be a useful technique to detect longitudinal stent deformation.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and anatomical features of acute longitudinal stent deformation: An intravascular ultrasound study

Inaba

Weisz

Kobayashi

et al. 2014

Cathet Cardio Intervent

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Assessment of optimum stent deployment by stent boost imaging: comparison with intravascular ultrasound

Cited by 28 publications

References 10 publications

Stent Boost Subtract Imaging for the Assessment of Optimal Stent Deployment in Coronary Ostial Lesion Intervention

Stent Boost Subtract Imaging for the Assessment of Optimal Stent Deployment in Coronary Ostial Lesion Intervention

Suppression of Wall Shear Stress inside Intracranial Aneurysms by Simple Stents

Prevalence and anatomical features of acute longitudinal stent deformation: An intravascular ultrasound study

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