Role of Intravascular Ultrasound in Comparing the Outcome of Direct Coronary Artery Stenting With Balloon Angioplasty and Elective Stenting

Abstract

Few years ago, stent have become an essential part of catheterization laboratory, and a dominant technique in interventional cardiology world wide. Coronary artery stenting is an established technique for the management of bailout situation after PTCA and it prevents acute closure and restenosis. As early as 1990, it was suggested that stents can be used as adjunctive treatment after dilation of vascular stenosis. Today direct stenting is a new strategy of stent deployment in which the stent deployed without predilation. This technique required special situation large diameter, absence of severe angulations and calcification, it reduce procedure time and exposure to fluoroscopy and reduce costs and less traumatic to the wall. IVUS played as essential role in developing an optimal strategy for stent deployment. It is an accurate method of visualizing stented coronary artery segment with great details in addition to assessing the geometry of stent expansion and vessel wall stent contact. This study aimed to compare conventional stenting group to direct stenting group as regards the achievement of optimal criteria of stent deployment as assessed by IVUS "MUSIC criteria (103)" together with the occurrence of various complications following both procedures e.g. dissection, plaque rupture, axial plaque shift and distal embolization. To the best of our knowledge this is the first study to perform this comparison between the two strategies using both QCA and IVUS imaging procedures.