Repeat stenting for the prevention of the early lumen loss phenomenon in patients with in-stent restenosis

Coronary Aneurysms After Drug-Eluting Stent Implantation

“…IVUS. All IVUS studies (30/40-MHz mechanical transducers) were performed using an automated pullback system (0.5 mm/s) and recorded on sVHS videotapes for subsequent off-line analysis (22,23). Incomplete DES apposition was defined as Ն1 stent strut clearly separated from the vessel wall, with blood speckling behind it, in a vessel segment not encompassing a side-branch exit (8 -11).…”

“…Incomplete DES apposition was defined as Ն1 stent strut clearly separated from the vessel wall, with blood speckling behind it, in a vessel segment not encompassing a side-branch exit (8 -11). Quantitative IVUS analyses were performed using a previously validated automatic contour detection system (EchoScan, Tomtec, Germany) (22,23). Diameters, areas (every 0.3 mm of DES length), and volumes of lumen, stent, and external elastic lamina were measured.…”

“…53, No. 22, 2009 Alfonso et al June 2, 2009June 2, :2053 Coronary Aneurysms After DES Implantation useful for identifying patients at higher risk for complications. Additional studies are required to identify patients at risk for adverse events and also to determine the most reasonable intervention for this challenging new entity.…”

Mechanisms of balloon angioplasty and repeat stenting in patients with drug-eluting in-stent restenosis

“…Four, in a previous mechanistic study we demonstrated that an "early lumen loss phenomenon" is frequently detected sub-acutely after BA (delay time of 45 min) in patients with ISR [27]. This problem is virtually abolished by repeat stent implantation [27]. Whether the striking morphometric OCT findings seen after BA in our current study might be related to this unique phenomenon remains speculative as delayed imaging after intervention was not obtained.…”

“…The high pressure used during our initial BA probably was able to favor a non-reversible plastic deformation of the vessel wall paving the way to facilitate the final results obtained by DES implantation [26]. Four, in a previous mechanistic study we demonstrated that an "early lumen loss phenomenon" is frequently detected sub-acutely after BA (delay time of 45 min) in patients with ISR [27]. This problem is virtually abolished by repeat stent implantation [27].…”