所属 医学部 医学科（東京女子医科大学病院） 職種 准教授
|表題||Intimal disruption affects drug-eluting cobalt-chromium stent expansion: A randomized trial comparing scoring and conventional balloon predilation.|
|掲載誌名||正式名：International journal of cardiology|
略 称：Int J Cardiol
|著者・共著者||JUJO Kentaro†, SAITO Katsumi, ISHIDA Issei, KIM Ahsung, SUZUKI Yuki, FURUKI Yuho, OUCHI Taisuke, ISHII Yasuhiro, SEKIGUCHI Haruki, YAMAGUCHI Junichi, OGAWA Hiroshi, HAGIWARA Nobuhisa|
Stent expansion remains one of the most important predictors of restenosis and subacute thrombosis, even with the use of drug-eluting stents. This study was designed to clarify the impact of lesion preparation on final stent expansion.
Sixty-six consecutive patients were included in this trial, and ultimately 52 enrolled non-calcified de novo lesions were randomly assigned to undergo single predilation with either a semi-compliant scoring balloon or a semi-compliant conventional balloon. Lesions were treated with a single 2.5- to 3.0-mm cobalt-chromium everolimus-eluting stent under optical coherence tomography (OCT) guidance without post-stenting dilation. Stent expansion was defined as the ratio of OCT-measured minimum stent area to the predicted stent area.
Stent expansion was significantly higher after predilation by a scoring balloon (68.0% vs. 62.1%, p=0.017) with similar stent lumen eccentricity (0.84 vs. 0.80, p=0.18). Intimal disruption was induced significantly more frequently (68.0% vs. 38.4%, p=0.035) and was more extensive in the scoring group (122° vs. 65°, p=0.038). Lesions with intimal disruption after predilation achieved significantly higher stent expansion than that without it (67.7% vs. 61.6%, p=0.023). One case in the conventional group required target lesion revascularization; however, any other adverse clinical events including death, myocardial infarction, and stent thrombosis were not observed up to 9months after PCI in both groups.
In this randomized study, pretreatment with a scoring balloon enhanced stent expansion partly through induction of intimal disruption.