Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position   Associate Professor
Article types Original article
Language English
Peer review Peer reviewed
Title Intimal disruption affects drug-eluting cobalt-chromium stent expansion: A randomized trial comparing scoring and conventional balloon predilation.
Journal Formal name:International journal of cardiology
Abbreviation:Int J Cardiol
ISSN code:01675273/18741754
Domestic / ForeginForegin
Publisher Elsevier
Volume, Issue, Page 221,23-31頁
Author and coauthor JUJO Kentaro†, SAITO Katsumi, ISHIDA Issei, KIM Ahsung, SUZUKI Yuki, FURUKI Yuho, OUCHI Taisuke, ISHII Yasuhiro, SEKIGUCHI Haruki, YAMAGUCHI Junichi, OGAWA Hiroshi, HAGIWARA Nobuhisa
Publication date 2016/10
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.
DOI 10.1016/j.ijcard.2016.07.002
PMID 27400292