The importance of acute luminal diameter in determining restenosis after coronary atherectomy or stenting.

Kuntz, Richard E.; Safian, Robert D.; Carrozza, Joseph P.; Fishman, Robert F.; Mansour, Michael; Baim, Donald S.

doi:10.1161/01.cir.86.6.1827

Cited by 330 publications

(143 citation statements)

References 30 publications

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“…Because optimal sizing of a device is mandatory to reduce the restenosis rate according to the "bigger is better" theory, 13) true vessel size given by IVUS would be very beneficial at this point.…”

Section: Discussionmentioning

confidence: 99%

The Influence of Diabetes Mellitus on Plaque Volume and Vessel Size in Patients Undergoing Percutaneous Coronary Intervention: An Intravascular Ultrasound Study

et al. 2004

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SUMMARYWe evaluated the influence of diabetes on plaque volume and vessel size at a reference segment in diabetic patients undergoing percutaneous coronary intervention using both angiograms and quantitative intravascular ultrasound. A total of 344 patients with 449 de novo coronary lesions including 97 diabetics (133 lesions) who underwent elective percutaneous coronary intervention under intravascular ultrasound guidance were included in this study. Eleven diabetic patients (19 lesions) received insulin and 52 patients (77 lesions) oral hypoglycemic drugs. The other 34 patients (37 lesions) received diet/exercise therapy alone. We measured vessel area (VA) and lumen area (LA) at proximal and distal reference segments by intravascular ultrasound, which were averaged. Plaque area (VA-LA) and % plaque area (100 × plaque area/VA) were subsequently calculated. Although VA was similar between diabetic and non-diabetic patients (13.46 ± 4.49 mm 2 in diabetics versus 14.11 ± 5.24 mm 2 in non-diabetics, P = 0.214), LA was smaller (6.51 ± 2.63 mm 2 versus 7.38 ± 3.08 mm 2 , P = 0.004) and % PA was larger (50.4 ± 11.7 versus 46.5 ± 11.3, P < 0.001) in diabetic patients, especially the group receiving a hypoglycemic drug or insulin. VA, LA, and % PA were similar between patients with and without insulin treatment. These results potentially might cause undersized device selection without intravascular ultrasound guidance. (Jpn Heart J 2004; 45: 573-580)

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Section: Discussionmentioning

confidence: 99%

The Influence of Diabetes Mellitus on Plaque Volume and Vessel Size in Patients Undergoing Percutaneous Coronary Intervention: An Intravascular Ultrasound Study

et al. 2004

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“…Suboptimal expansion of the balloon catheter, which is often observed during angioplasty of highly calcified lesions, causes mild increase of the vessel diameter but at the same time a large injury to the endothelium [4]. An attempt to expand the artery "at all costs" by using highpressure non-compliant balloons (above 20 atm) may end with rupture of the balloon or the occurrence of the socalled hourglass phenomenon -an excessive expansion of the balloon catheter directly before and after the lesion with a risk of an extensive dissection and even perforation of the vessel.…”

Section: Discussionmentioning

confidence: 99%

Rotational atherectomy of right coronary artery complicated with stent dislodgment and ostial dissection –

Zimoch¹,

Gaul²,

Wojtczak³

et al. 2012

pwki

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“…We previously reported a similar finding, 11) and other studies have also shown that a small minimum lumen diameter or a small percent diameter stenosis after the procedure are predictive factors of major adverse cardiac events after coronary stenting. 12,13) Therefore, since the final result (residual diameter stenosis) after coronary stenting should be one of the most important factors for target lesion revascularization, interventional cardiologists should achieve the optimal final diameter stenosis (≤ 20%) after stenting in order to avoid target lesion revascularization. In the present study, we achieved a final diameter stenosis of ≤ 20% in 79 (91.9%) of the 86 patients.…”

Section: Clinical and Angiographic Outcomes After Coronary ML Penta Smentioning

confidence: 99%

Clinical and Angiographic Outcomes After Multi-Link PENTA Stent Implantation in Japanese Patients With Coronary Artery Disease

2005

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SUMMARYThe flexibility of the Multi-Link (ML) PENTA stent with platform 0.09 to 0.12-mmthick struts and 12% to 16% metal/artery coverage was improved to facilitate safe delivery in complex coronary lesions. The present study was designed to evaluate the clinical (9-month) and angiographic (6-month) results of the ML PENTA stent in complex coronary lesions (modified American College of Cardiology/American Heart Association lesion type B2 or C) and to determine independent factors correlated with target lesion revascularization. The study population consisted of 86 consecutive patients who had undergone successful coronary ML PENTA stent implantation for coronary artery disease from May 2003 to July 2004 in our hospital. During the follow-up period, cardiac events were documented in 21 (24.4%) of the 86 patients. Target lesion revascularization was required in 16 (18.6%) of the 86 patients. Single logistic regression analysis showed that target lesion revascularization was significantly correlated with lesion length > 2.0 cm, residual percent diameter stenosis after the procedure > 20%, and multiple stents. Multiple logistic regression analysis showed that residual percent diameter stenosis after procedure > 20% (P = 0.0125, odds ratio = 11.585) was the significant explanatory factor of target lesion revascularization. The results of the present study suggest that 9-month clinical and 6-month angiographic outcomes in patients with coronary artery disease treated using the ML PENTA stent were excellent and target lesion revascularization after coronary ML PENTA stent implantation was influenced by residual percent diameter stenosis after the procedure. (Int Heart J 2005; 46: 997-1006) Key words: Multi-Link PENTA stent, Target lesion revascularization, Residual percent diameter stenosis THE flexibility of the Multi-Link (ML) PENTA stent (Guidant, Santa Clara, California) with platform 0.09 to 0.12-mm-thick struts and 12% to 16% metal/ artery coverage, which is a recently developed stent, has been improved to facilitate safe delivery in complex coronary lesions and the stent maintains sidebranch access with the possibility to expand the cell toward the side branch up to From the

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The importance of acute luminal diameter in determining restenosis after coronary atherectomy or stenting.

Cited by 330 publications

References 30 publications

The Influence of Diabetes Mellitus on Plaque Volume and Vessel Size in Patients Undergoing Percutaneous Coronary Intervention: An Intravascular Ultrasound Study

The Influence of Diabetes Mellitus on Plaque Volume and Vessel Size in Patients Undergoing Percutaneous Coronary Intervention: An Intravascular Ultrasound Study

Rotational atherectomy of right coronary artery complicated with stent dislodgment and ostial dissection –

Clinical and Angiographic Outcomes After Multi-Link PENTA Stent Implantation in Japanese Patients With Coronary Artery Disease

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