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

Abstract

Background. Coronary stenting in conjunction with coronary angioplasty is a valuable tool for treatment of severe coronary dissection and is effective in reducing the frequency of restenoses. Evidence is increasing that the lumen gain within the stent is negatively correlated with the rate of subacute closures and restenoses. Since the assessment of radiolucent coronary stents and complex lumen morphologies by angiography is limited, we hypothesized that the use of a balloon catheter with integrated intravascular ultrasound (IVUS) facility for stent deployment and guidance of its expansion could improve the acute lumen gain without relevant procedural prolongation. Methods and Results. Deployment of a single Palmaz-Schatz coronary stent with the combined imaging balloon catheter alone was successful in 18 of 20 patients eligible for this study. Corresponding measurements of minimal lumen diameter (MLD) by angiography and IVUS could be performed in 16 patients, revealing a close correlation between the two methods within the reference segments (3.10±0.38 and 3.08±0.43 mm, r=.79). Despite an adequate angiographic result in most patients after stent deployment, IVUS showed smaller MLD within the stented segment (2.15±0.23 mm) compared with angiography (2.63±0.26 mm, P