STENTY WEWNATRZWIENCOWE. ANGIOGRAFICZNA I ULTRASONOGRAFICZNA OCENA PO WSZCZEPIENIU I W BADANIACH ODLEGLYCH

Introduction of intracoronary stents to the clinical practise improved treatment of complications of percutaneous transluminal coronary angioplasty (PTCA) and reduced restenosis rate. The purpose of the present study was to assess the long-term effectiveness of the Palmaz-Schatz stent implantation following coronary dissection after PTCA in 21 patients, and to compare the accuracy of quantitative coronary angiography (QCA) and intravascular ultrasound (IVUS) in assessment of coronary flow immediately after stent implantation and 6-8 months later, during follow-up. Stent implantation was successful in all patients. The IVUS revealed asymmetric deployment of stent in 4 (19%) patients. At the follow-up visit, angigraphically diagnosed restenosis was found in 7 (33%) patients: lumen diameter (LD) decreased by 0.75 ± 0.18 mm (p2 (p2) and by the elastic recoil and stent collapse (decrease of LD by 0.16 ± 0.08 mm and LA by 0.86 ± 0.32 mm²). The results of QCA and IVUS were similar immediately after stent implantation, however, at the follow-up assessment the LD and LA values were significantly higher using QCA compared with IVUS measurements. In conclusion, (1) stent implantation is a highly effective method for treatment of coronary dissections complicating PTCA; (2) endoluminal proliferation is a predominant mechanism of restenosis, whereas stent collapse plays a minor role in this process; and (3) IVUS is better than QCA for monitoring stent implantation and for stent assessment during follow-up.