Relation of stent design and stent surface material to subsequent in-stent intimal hyperplasia in coronary arteries determined by intravascular ultrasound
Section snippets
Patients and lesions:
Consecutive patients from 4 studies who required IVUS follow-up at 6 months were included in this study. A differenct stent design was used in each study. Lesion inclusion criteria were similar for the 4 studies. Coronary lesions had to be located in a native artery of 2.5 to 4.0 mm diameter and lesion length (up to 15 mm for Multi-Link stents [Guidant, Santa Clara, California], Palmaz-Schatz stents [Johnson & Johnson, Warren, New Jersey), and NIR stents [Scimed, Maple Grove, Michigan], and up
Results
Patient demographics are listed in Table 1.
Discussion
This IVUS study on 4 different stent designs and 2 different stent surface materials indicates that stent design, stent surface material, and diabetes mellitus have an important impact on the amount of IH thickness after coronary stent placement.
References (23)
- et al.
Angiographic and intravascular ultrasound predictors of in-stent restenosis
J Am Coll Cardiol
(1998) - et al.
Predictors of restenosis after coronary stent implantation
J Am Coll Cardiol
(1998) - et al.
Intravascular ultrasound predictors of angiographic restenosis in lesions treated with Palmaz-Schatz Stents
J Am Coll Cardiol
(1998) - et al.
Validation of the in vivo intravascular ultrasound measurement of in-stent neointimal hyperplasia volumes
J Am Coll Cardiol
(1998) - et al.
The influence of diabetes mellitus on acute and late clinical outcomes following coronary stent implantation
J Am Coll Cardiol
(1998) - et al.
Restenosis and proportional neointimal response to coronary artery injuryresults in a porcine model
J Am Coll Cardiol
(1992) - et al.
In-stent restenosis contributions of inflammatory responses and arterial injury to neointimal hyperplasia
J Am Coll Cardiol
(1998) - et al.
Final results of a randomized trial comparing the NIR stent to the Palmaz-Schatz stent for narrowing in native coronary arteries
Am J Cardiol
(2001) - et al.
Restenosis after coronary placement of various stent types
Am J Cardiol
(2001) - et al.
A randomized comparison of coronary stent placement and balloon angioplasty in the treatment of coronary artery disease
N Engl J Med
(1994)
A comparison of balloon expandable stent implantation with balloon angioplasty in patients with coronary artery disease
N Engl J Med
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