Nonrandomized Comparison of Coronary Stenting Under Intravascular Ultrasound Guidance of Direct Stenting Without Predilation Versus Conventional Predilation With a Semi-Compliant Balloon Versus Predilation With a New Scoring Balloon

Jose de Ribamar Costa, Gary S. Mintz, Stéphane G. Carlier, Roxana Mehran, Paul Teirstein, Koichi Sano, Xuebo Liu, Joanna Lui, Yingbo Na, Celia Castellanos, Sinan Biro, Lockeshi Dani, Jason Rinker, Issam Moussa, George Dangas, Alexandra J. Lansky, Edward M. Kreps, Michael Collins, Gregg W. Stone, Jeffrey W. MosesMartin B. Leon

Research output: Contribution to journalArticle

39 Scopus citations

Abstract

This study was conducted to determine the influence of lesion preparation using the AngioSculpt balloon on final stent expansion. Stent expansion remains an important predictor of restenosis and subacute thrombosis, even in the drug-eluting stent (DES) era. In these patients, the role of different predilation strategies has yet to be established. Two hundred ninety-nine consecutive de novo lesions treated with 1 >2.5-mm DES (Cypher or Taxus) under intravascular ultrasound guidance without postdilation, using 3 implantation strategies, were studied: (1) direct stenting without predilation (n = 145), (2) predilation with a conventional semi-compliant balloon (n = 117), and (3) predilation with the AngioSculpt balloon (n = 37). Stent expansion was defined as the ratio of intravascular ultrasound-measured minimum stent diameter and minimum stent area to the manufacturer's predicted stent diameter and area. These ratios were larger after AngioSculpt predilation, and a greater percentage of stents had final minimum stent areas >5.0 mm2 (another commonly accepted criterion of adequate DES expansion). Lesion morphology, stent and lesion length, and reference vessel size did not affect DES expansion. In conclusion, in this observational, nonrandomized study, pretreatment with the AngioSculpt balloon enhanced stent expansion and minimized the difference between predicted and achieved stent dimensions.

Original languageEnglish (US)
Pages (from-to)812-817
Number of pages6
JournalAmerican Journal of Cardiology
Volume100
Issue number5
DOIs
StatePublished - Sep 1 2007
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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    de Ribamar Costa, J., Mintz, G. S., Carlier, S. G., Mehran, R., Teirstein, P., Sano, K., Liu, X., Lui, J., Na, Y., Castellanos, C., Biro, S., Dani, L., Rinker, J., Moussa, I., Dangas, G., Lansky, A. J., Kreps, E. M., Collins, M., Stone, G. W., ... Leon, M. B. (2007). Nonrandomized Comparison of Coronary Stenting Under Intravascular Ultrasound Guidance of Direct Stenting Without Predilation Versus Conventional Predilation With a Semi-Compliant Balloon Versus Predilation With a New Scoring Balloon. American Journal of Cardiology, 100(5), 812-817. https://doi.org/10.1016/j.amjcard.2007.03.100