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Focal wall overstretching after high‐pressure coronary stent implantation does not influence restenosis
Author(s) -
Nakamura Shigeru,
Francesco Lucia Di,
Finci Leo,
Reimers Bernhard,
Adamian Milena,
Mario Carlo Di,
Colombo Antonio
Publication year - 1999
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/(sici)1522-726x(199909)48:1<24::aid-ccd6>3.0.co;2-k
Subject(s) - restenosis , intravascular ultrasound , medicine , lumen (anatomy) , ultrasound , balloon , coronary stent , cardiology , stent , radiology
To determine if vessel wall overstretching during coronary stenting is associated with a higher restenosis rate, the intravascular ultrasound morphological evaluation was performed following ultrasound criteria. A total of 468 lesions with successful coronary Palmaz‐Schatz stenting guided by intravascular ultrasound were classified into the no overstretching group (n = 295) and the overstretching group (n = 147). There were 26 lesions not classifiable due to the poststent morphology. Balloon‐to‐vessel ratio was 1.12 ± 0.17 in the no focal overstretching group and 1.20 ± 0.20 in the overstretching group ( P < 0.0002). Follow‐up angiogram was performed in 77% of no focal overstretching group and in 75% of the focal overstretching group. The restenosis rate of the no focal overstretching group was 19.8% and 20.9% in the focal overstretching group, respectively ( P = 0.65). Focal overstretching was more frequent following balloon oversizing. No increase in restenosis rate, found in focal overstretched stented lesions, leads us to the hypothesis of a regulation of smooth‐muscle‐cell proliferation activated by the normalization of blood flow and of shear stress, when stent implantation succeeds in optimally improving the lumen. Cathet. Cardiovasc. Intervent. 48:24–30, 1999. © 1999 Wiley‐Liss, Inc.