Focal wall overstretching after high-pressure coronary stent implantation does not influence restenosis

Shigeru Nakamura, Lucia Di Francesco, Leo Finci, Bernhard Reimers, Milena Adamian, Carlo Di Mario, Antonio Colombo

Research output: Contribution to journalArticle

Abstract

To determine if vessel wall overstretching during coronary stenting is associated with a higher restenosis rate, the intravascular ultrasound morphological evaluation was performed following ultrasound criteria. A total of 468 lesions with successful coronary Palmaz-Schatz stenting guided by intravascular ultrasound were classified into the no overstretching group (n = 295) and the overstretching group (n = 147). There were 26 lesions not classifiable due to the poststent morphology. Balloon-to-vessel ratio was 1.12 ± 0.17 in the no focal overstretching group and 1.20 ± 0.20 in the overstretching group (P <0.0002). Follow-up angiogram was performed in 77% of no focal overstretching group and in 75% of the focal overstretching group. The restenosis rate of the no focal overstretching group was 19.8% and 20.9% in the focal overstretching group, respectively (P = 0.65). Focal overstretching was more frequent following balloon oversizing. No increase in restenosis rate, found in focal overstretched stented lesions, leads us to the hypothesis of a regulation of smooth-muscle-cell proliferation activated by the normalization of blood flow and of shear stress, when stent implantation succeeds in optimally improving the lumen.

Original languageEnglish
Pages (from-to)24-30
Number of pages7
JournalCatheterization and Cardiovascular Interventions
Volume48
Issue number1
DOIs
Publication statusPublished - Sep 1999

Keywords

  • Coronary stent implantation
  • Intravascular ultrasound
  • Restenosis
  • Vessel overstretching

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

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