Stent visualization methods to guide percutaneous coronary interventions and assess long-term patency

Ghafari, Chadi; Carlier, Stéphane

doi:10.4330/wjc.v13.i9.416

Cited by 5 publications

(4 citation statements)

References 162 publications

(160 reference statements)

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“…QCA remains an important, readily available, and easy-to-use tool during PCIs allowing for a more practical and standardized angiography-based approach. QCA is particularly useful for the evaluation of the minimal lumen diameter, the reference vessel diameter, the diameter stenosis percentage, the lesion length, the acute gain, and late loss [14]. Our data failed to show any correlation between the expected stent diameter and the QCAderived one.…”

Section: Discussioncontrasting

confidence: 73%

“…The software enhances stent visibility, fading out anatomical structures and background noise [25]. SB was found to have good correlation with IVUS regarding stent diameter and was found to be superior to quantitative coronary angiography (QCA) [14,17,24,[27][28][29][30][31].…”

Section: Introductionmentioning

confidence: 97%

“…Although optimizing stent implantation under intravascular imaging guidance is widely supported by the current literature [11][12][13][14][15][16][17], its routine clinical use remains limited due to the added time and cost to the procedure along with the image interpretation difficulties. Despite conventional angiography often falling behind in the detection of stent underexpansion and presenting a suboptimal accuracy assessing stent position, it is still carried out during routine clinical practice especially with newer generation scaffolds that are implanted at a higher pressure followed by a post-dilatation step and rely on the radiopaque nature of the material used for visualization.…”

Section: Introductionmentioning

confidence: 99%

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Clinical Validation of a New Enhanced Stent Imaging Method

et al. 2023

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(1) Background: Stent underexpansion is the main cause of stent thrombosis and restenosis. Coronary angiography has limitations in the assessment of stent expansion. Enhanced stent imaging (ESI) methods allow a detailed visualization of stent deployment. We qualitatively compare image results from two ESI system vendors (StentBoost™ (SB) and CAAS StentEnhancer™ (SE)) and report quantitative results of deployed stents diameters by quantitative coronary angiography (QCA) and by SE. (2) Methods: The ESI systems from SB and SE were compared and graded by two blinded observers for different characteristics: 1 visualization of the proximal and distal edges of the stents; 2 visualization of the stent struts; 3 presence of underexpansion and 4 calcifications. Stent diameters were quantitatively measured using dedicated QCA and SE software and compared to chart diameters according to the pressure of implantation. (3) Results: A total of 249 ESI sequences were qualitatively compared. Inter-observer variability was noted for strut visibility and total scores. Inter-observer agreement was found for the assessment of proximal stent edge and stent underexpansion. The predicted chart diameters were 0.31 ± 0.30 mm larger than SE diameters (p < 0.05). Stent diameters by SE after post-dilatation were 0.47 ± 0.31 mm smaller than the post-dilation balloon diameter (p < 0.05). SE-derived diameters significantly differed from QCA; by Bland–Altman analysis the bias was −0.37 ± 0.42 mm (p < 0.001). (4) Conclusions: SE provides an enhanced visualization and allows precise quantitative assessment of stent expansion without the limitations of QCA when overlapping coronary side branches are present.

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Section: Discussioncontrasting

confidence: 73%

Section: Introductionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

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Clinical Validation of a New Enhanced Stent Imaging Method

et al. 2023

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“…We used ESV, a fluoroscopy-based evaluation method, as an alternative. ESV has been shown to be a reliable alternative to intravascular imaging in some studies [ 41 , 49 , 50 , 51 , 52 , 53 ]. In our study, all the lesions were evaluated for stent expansion using intravascular ultrasonography or ESV immediately after stent deployment at a nominal pressure during PCI.…”

Section: Discussionmentioning

confidence: 99%

Safety and Efficacy of Post-Dilation in Percutaneous Coronary Intervention Using Polymer-Free Ultrathin Strut Sirolimus-Probucol Coated Drug-Eluting Stents

Shin,

Won,

Yang

et al. 2023

Medicina

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Background and Objectives: Polymer-free ultrathin strut sirolimus- and probucol-eluting stents (PF-SES) are recognized as safe and effective in diverse patient populations, although the implications of post-dilation during stent implantation remain underexamined. Materials and Methods: In this study, patients implanted with PF-SES at Gachon University Gil Medical Center between December 2014 and February 2018 were evaluated. Major adverse cardiovascular events (MACE), encompassing nonfatal myocardial infarction (MI), nonfatal stroke, and cardiovascular death were identified as primary outcomes, with secondary outcomes including target vessel revascularization (TVR), target lesion revascularization (TLR), and in-stent restenosis (ISR). Results: Of the 384 initial patients, 299 were considered eligible for analysis. The groups, delineated by those undergoing post-dilation (143 patients) and those not (156 patients), exhibited comparable rates of primary outcomes [hazard ratio (HR), 2.17; 95% confidence interval (CI), 0.40 to 11.87; p = 0.37]. The outcomes remained consistent irrespective of the post-dilation status and were similarly unaffected in multivariate analyses (HR, 2.90; 95% CI, 0.52 to 16.34; p = 0.227). Conclusions: These results suggest that the clinical outcomes of patients with post-dilation were similar to that of those without post-dilation in those with the polymer-free sirolimus- and probucol-eluting stents.

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The PolyCraft Polymer–Metal Hybrid Smart Stent System: The Future of Cardiovascular Blood Pressure Management

Wang,

Oyunbaatar,

Jeong

et al. 2024

Adv Funct Materials

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To address the complication of in‐stent restenosis that occurs with traditional stent treatments, this study proposes an innovative hybrid smart stent‐based medical system. This approach allows to overcome the limitations of existing bare metal or polymer‐based smart stents, which interfere with radio frequency signals, less deformability, or do not provide adequate radial support, respectively. The proposed hybrid stent, which uses a Co/Cr–polycaprolactone (PCL)–Co/Cr configuration connected by a unique dual inverted Y‐type connector for metal–polymer integration is integrated with a LC wireless pressure sensor fabricated through a semiconductor process. The fabricated hybrid stent made by laser machining and custom‐made 3D printing, offers excellent properties such as radial strength (0.125 N/mm) and flexibility (2 N mm2) and provides intravascular information to the outside through the integrated sensor without signal degradation. After basic experiments using a phantom, animal experiments are conducted by combining the fabricated sensor with artificial blood vessel, and the results measured by the external antenna system are consistent with the results of a commercial reference sensor. The proposed wireless sensor‐based smart stents and artificial blood vessels aim to gather diverse patient health data for integration with artificial intelligence, laying the groundwork for next‐generation medical innovation.

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Stent visualization methods to guide percutaneous coronary interventions and assess long-term patency

Cited by 5 publications

References 162 publications

Clinical Validation of a New Enhanced Stent Imaging Method

Clinical Validation of a New Enhanced Stent Imaging Method

Safety and Efficacy of Post-Dilation in Percutaneous Coronary Intervention Using Polymer-Free Ultrathin Strut Sirolimus-Probucol Coated Drug-Eluting Stents

The PolyCraft Polymer–Metal Hybrid Smart Stent System: The Future of Cardiovascular Blood Pressure Management

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