Impact of stent deployment pressure and poststenting dilatation on the outcome of elective percutaneous coronary intervention

Abstract

Background: High-pressure stent deployment was proposed as a strategy that ensures complete stent apposition but its relation to outcome is markedly debated. Objective: To verify the influence of stent deployment pressure and poststenting dilatation on the outcome of percutaneous coronary intervention. Methods: We included 120 patients with single vessel coronary artery disease who were subjected to elective stenting. Patients were divided into two groups: group A, high deployment pressure ≥16 atm and group B, low deployment pressure 8-12 atm. Group B was subdivided into two subgroups according to whether patients underwent poststenting dilatation (subgroup B1) or not (subgroup B2). Clinical and angiographic 6-month follow-up was performed. Results: The mean stent deployment pressure was higher in group A compared to group B (19±3 vs 10±2, P=0.01). There was no statistically significant difference found between groups A and B regarding major adverse cardiac events (16.7% vs 23.3%, P=0.404) including target lesion revascularization (5% vs 6.7%, P=0.970) and late loss (1.1 mm ±0.9 mm vs 1.22 mm ±0.85 mm, P=0.454), yet the restenosis rate was significantly lower in group A (23.3% vs 43.3%, P=0.032). Subgroup B1 showed a significantly lower restenosis rate compared to subgroup B2 (26.7% vs 60%, P=0.018), yet there was no significant difference between both subgroups regarding major cardiac adverse events (20% vs 26.7%, P=0.761). Conclusion: High-pressure stent deployment was associated with significant reduction in the restenosis rate but not in the 6 months major adverse cardiac events. Poststenting dilatation resulted in a significantly lower restenosis rate when applied in the low-pressure stent deployment group.