Author + information
- Tatsuhiro Fujimura,
- Mitsuaki Matsumura,
- Bernhard Witzenbichler,
- David C. Metzger,
- Michael Rinaldi,
- Peter L. Duffy,
- Giora Weisz,
- Thomas D. Stuckey,
- Ziad Ali,
- Aaron Crowley,
- Gary Mintz,
- Gregg Stone and
- Akiko Maehara
We compared various stent expansion indices (St-Exp) to predict clinical outcomes.
ADAPT-DES was a prospective, multicenter registry of 8582 pts undergoing PCI with DES in which post-stent IVUS was available for 2166 lesions in 1847 pts. Conventional St-Exp was defined as minimal stent area (MSA)/average of reference lumen area. For Huo-Kassab (H-K) or linear model, 1) stent area was measured every 1 mm; 2) the ideal lumen area without a stenosis was computed for each slice using both the H-K model (accounting for natural vessel tapering due to sidebranches) and linear model (assuming uniform vessel tapering); and 3) stent/ideal lumen area for each slice was calculated to identify the minimal St-Exp along the entire stent. In addition, stent/vessel area was calculated at the min St-Exp and at the MSA sites. Stent asymmetry and stent eccentricity were calculated. Multivariable Cox proportional hazard model was adjusted for procedural and anatomical factors.
MSA, conventional St-Exp, Min St-Exp by either the H-K or linear model, and stent asymmetry or eccentricity were not associated with 2-yr clinically-driven TLR, while MSA/vessel area or stent/vessel area at the site of min St-Exp by either the H-K or the linear model were associated with 2-yr clinically-driven TLR (Table).
Stent/vessel area at the site of the MSA or at the site of min St-Exp considered in a vessel tapering model was superior to traditional measures of ST-Exp to predict clinically-driven TLR after DES.
|Tested parameters||Adjusted HR (95% CI)||Adjusted p Value|
|MSA, mm2||0.97 (0.84, 1.13)||0.73|
|Conventional St-Exp, %||1.00 (0.98, 1.02)||0.94|
|MSA/vessel area at MSA site, %||0.96 (0.94, 0.99)||0.008|
|Min St-Exp by H-K model, %||0.99 (0.98, 1.01)||0.65|
|Stent /vessel area at min St-Exp by H-K model, %||0.97 (0.94, 1.00)||0.04|
|Min St-Exp by linear model, %||0.99 (0.97, 1.01)||0.53|
|Stent/vessel area at min St-Exp by linear model, %||0.97 (0.94, 1.00)||0.046|
|Stent asymmetry (min/max stent diameter in the entire stent)||0.67 (0.04, 11.43)||0.78|
|Stent eccentricity (min/max stent diameter in the same slice)||3.73 (0.09, 159.1)||0.49|
Posters Hall_Hall A
Sunday, March 29, 2020, 12:30 p.m.-1:15 p.m.
Session Title: Interventional Cardiology: Intravascular Imaging and Coronary Physiology 5
Abstract Category: 23. Interventional Cardiology: Intravascular Imaging and Coronary Physiology
Presentation Number: 1305-046
- 2020 American College of Cardiology Foundation