The effect of intravascular ultrasound usage for the implantation of drug-eluting stent on the rate of acute thrombosis and restenosis

Abstract

Objective: Major setbacks with the use of stents, which are widely used in the treatment of coronary artery dis­ease, are development of acute thrombosis during early term and restenosis during the long term. No procedures have been able to completely prevent formation of early stent thrombosis (ST) and in-stent restenosis (ISR) up to now. The aim of the present study was to investigate the impact of intravascular ultrasonography (IVUS) guidance on angiographic outcomes of drug eluting stent (DES) im­plantation. Methods: In this study, we included 23 patients who re­ceived DES with the guidance of IVUS and 23 patients receiving the DES without IVUS. The patients were scru­tinized for their sixth month control angiographies. The angiographic results were compared between the groups. Results: The basic angiographic and clinical features were similar between the groups (p>0.05). The minimal luminal diameter after the percutaneous intervention was higher in Group I than Group 2 (3.2±0.3. 2.9±0.4, p=0.03). Acute ST, late lumen loss and stent restenosis rates were comparable between the groups (p>0.05). On the other hand, among the patients that did not receive IVUS three patients were presented with stent restenosis (SR) and one patient developed acute ST. Conclusion: The present results indicate that the use of IVUS for the implantation of DES can increase the suc­cess rate of the intervention. Consequently, IVUS can be considered as a complementary method during DES im­plantation. J Clin Exp Invest 2013; 4 (1): 84-89

Keywords

• Drug eluting stent, intravascular ultrasonog­raphy, percutaneous coronary intervention

İlaç kaplı stent implantasyonunda intravasküler ultrason kullanımının akut tıkanma ve restenoz oranına etkisi

Öz

Amaç: Koroner arter hastalığının tedavisinde yaygın olarak kullanılan stentlerle ilgili en büyük problem erken dönemde akut tromboz, geç dönemde ise restenoz geli­şimidir. Şimdiye kadar hiçbir girişim stent trombozu (ST) ve stent restenozu (SR) gelişimini tamamıyla engelleye­memiştir. Bu çalışmanın amacı ilaç kaplı stent (İKS) imp­lantasyonu sırasında intravasküler ultrasonografi (IVUS) kılavuzluğunun anjiyografik sonuçlar üzerine etkisini araştırmaktır. Yöntemler: Çalışmaya IVUS kılavuzluğunda İKS uygu­lanan 23 hasta ve IVUS yapılmaksızın direkt anjiyografi kılavuzluğunda İKS uygulanan 23 hasta alındı. Tüm has­taların altıncı ay kontrol anjiyografileri yapıldı. Anjiyografik sonuçlar gruplar arasında karşılaştırıldı. Bulgular: Gruplar arasında temel anjiyografik ve klinik özellikler benzerdi (p >0,05). İşlem sonrası stent içi mi­nimal lümen çapı (SİMLÇ) IVUS yapılanlarda, IVUS ya­pılmayanlardan daha büyüktü (3,2±03. 2,9±0,4, p=0,03). Akut ST, geç lümen kaybı ve SR oranları ise iki grup arasında benzerdi (p>0,05). İntravasküler ultrasonografi yapılanlarda bir olguda SR tespit edilirken, akut ST göz­lenmedi. IVUS yapılmayanlarda ise üç hastada SR ve bir hastada akut ST gözlendi. Sonuç: Mevcut çalışma ile gösterildi ki İKS implantasyo­nu sırasında IVUS kullanımı girişim başarısını artırabilir. İlaç salınımlı stent implantasyonu sırasında IVUS kullanı­mı işlemi tamamlayıcı bir fonksiyon görebilir.

Anahtar Kelimeler

• İlaç salınımlı stent, intravasküler ult­rason, perkütan koroner girişim

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