Abstract
We sought to determine the outcome with undersized drug-eluting stents for percutaneous coronary intervention of saphenous vein graft lesions. Using intravascular ultrasound guidance, 209 saphenous vein graft lesions were treated with drug-eluting stents (153 sirolimus-eluting and 56 paclitaxel-eluting stents). The lesions were divided into 3 groups according to the ratio of the stent diameter to the average intravascular ultrasound reference lumen diameter: group I, <0.89; group II, 0.9 to 1.0; and group III, >1.0. Angiographic no-reflow was defined as a Thrombolysis In Myocardial Infarction flow grade of 0, 1, and 2 after percutaneous coronary intervention. Plaque intrusion was defined as tissue extrusion through the stent struts. Stent malapposition was defined as one or more stent struts that had clearly separated from the vessel wall with evidence of blood speckles behind the strut. No significant differences were found in the use of distal protection devices (group I, 44%; group II, 35%; and group III, 36%; p = 0.5); and no significant differences were found in the incidence of stent malapposition among the 3 groups (group I, 21%; group II, 42%; and group III, 52%; p = 0.001). The plaque intrusion area (group I, 0.13 +/- ...Continue Reading
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