Primary and mid-term outcome of sirolimus-eluting stent implantation with angiographic guidance alone.
Primary and mid-term outcome of sirolimus-eluting stent implantation with angiographic guidance alone.
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DOI：
10.1016/j.jjcc.2007.09.002
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发表时间：
2008-02
影响因子：
2.5
通讯作者：
H. Fujimoto;Susumu Tao;T. Dohi;S. Ito;J. Masuda;M. Haruo;Y. Fujimoto;A. Maehara;T. Yamaguchi;S. Ishiwata;M. Ohno
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文献类型：
--
作者：
H. Fujimoto;Susumu Tao;T. Dohi;S. Ito;J. Masuda;M. Haruo;Y. Fujimoto;A. Maehara;T. Yamaguchi;S. Ishiwata;M. Ohno
血管内超声（IVUS）用于西罗莫司洗脱支架（SES）植入的有效性和可靠性存在争议。我们调查的主要和中期结果的SES部署与血管造影引导相比，IVUS guidance.METHODS和血管造影引导部署在480原发病变的459例患者（341病变治疗没有IVUS和139病变治疗使用IVUS）; 368病变进行了后续冠状动脉造影。非IVUS组和IVUS组之间的晚期管腔丢失、支架内再狭窄（ISR）率和靶病变血运重建（TLR）率无显著差异。除TLR外，两组均未发生急性血栓形成或其他主要不良心脏事件。多因素Logistic回归分析显示，无IVUS的SES植入不是再狭窄的独立危险因素。另一方面，在一种情况下，靶血管重建是困难的，因为贴壁不良的SES先前植入没有IVUS.CONCLUSIONSFor病变的支架尺寸和终点是决定从血管造影信息单独，血管引导的SES植入是安全的，并提供了一个良好的中期结果，是与IVUS引导的SES支架部署。IVUS有助于复杂病变支架尺寸的确定，减少并发症的发生。
BACKGROUNDUsefulness and efficacy of intravascular ultrasound (IVUS) for the implantation of sirolimus-eluting stent (SES) is controversial. We investigated the primary and mid-term results of SES deployment with angiographic guidance comparing with IVUS guidance, retrospectively.METHODS AND RESULTSSESs were deployed in 480 de novo lesions of 459 patients (341 lesions treated without IVUS and 139 lesions treated using IVUS); 368 lesions underwent follow-up coronary angiography. Late luminal loss, in-stent restenosis (ISR) rate and target lesion revascularization (TLR) rate were not significantly different between the non-IVUS group and the IVUS group. There was no acute thrombosis or other major adverse cardiac events except for TLR in both groups. Multivariate logistic regression analysis showed that SES implantation without IVUS was not an independent risk factor for restenosis. On the other hand, in one case, target-vessel revascularization was difficult because of the mal-apposition of the SES previously implanted without IVUS.CONCLUSIONSFor lesions for which stent size and endpoint are decided from angiographic information alone, angio-guided SES implantation is safe and provides a good mid-term outcome that is comparable to the IVUS-guided SES stent deployment., while IVUS may be helpful to decide stent size for complex lesions and reduce possible complications.