Ultrasound guidance of Palmaz-Schatz intracoronary stenting with a combined intravascular ultrasound balloon catheter.

Abstract

This study demonstrates the application of a combined imaging balloon catheter for delivery and ultrasound-guided expansion of Palmaz-Schatz coronary stents. IVUS offered a comprehensive insight into the stented coronary segments, revealing a substantial overestimation of stent dimensions by angiography. IVUS guidance led to a significant improvement of stent expansion. This additional lumen gain, which was not discernible by angiography in most patients, might result in a reduction of subacute stent thromboses as well as restenoses.

Randomized Comparison of Coronary Stent Implantation Under Ultrasound or Angiographic Guidance to Reduce Stent Restenosis (OPTICUS Study)

“…However, some of these drawbacks might be attenuated in the future by use of smaller and combined devices. 6,26 In conclusion, this study does not support the routine use of intracoronary ultrasound during stent implantation to improve outcome. Angiography-guided optimization of tubular coronary stents can be performed with comparable angiographic and clinical long-term results.…”

“…1,2,3,4 Intravascular ultrasound guidance has been used to optimize stent expansion in order to minimize the risk of subacute stent thrombosis. 5 The resulting larger stent dimensions 6,7 may, furthermore, contribute to a reduction of restenosis. 8,9 To assess the effect of ultrasound guidance on stent restenosis, we conducted a multicenter, randomized study comparing stent implantation under intravascular ultrasound guidance with stent implantation under angiography guidance in intravascular ultrasoundexperienced centers.…”

Intravascular ultrasound-guided optimized stent deployment Immediate and 6 months clinical and angiographic results from the Multicenter Ultrasound Stenting in Coronaries Study (MUSIC Study)

“…The reproducibility of intravascular ultrasound measurements within coronary stents has previously been described for electronic and recently for mechanical systems. However, all imaging catheters used in this study were tested after every procedure for correct distance calibration by imaging cylindrical phantoms with an internal diameter of 2·0 to 5·0 mm [9,10] . For the purpose of the study, intravascular ultrasound was performed after stent implantation to judge adequate stent expansion.…”

Implante de Stent guiado por ultrassom intracoronariano melhora desfechos: meta-análise de ensaios randomizados

“…The conceptual framework for the hypothesis that IVUSguided percutaneous coronary intervention would result in better long-term angiographic and clinical outcomes when compared to the standard strategy (angiographicguided only) is based on the observation that IVUS examination after stenting allows a safe and controlled aggressive post-dilatation, with large final diameters 2,3 . Colombo et al 4 were among the first to show that IVUS guided coronary stenting is safe, feasible and provides a better apposition of the prosthesis to the vascular wall than that obtained in the procedure without IVUS.…”