Imaging to optimise stent deployment
Revision as of 07:04, 18 November 2018 by Amirfaour (talk | contribs) (Amirfaour moved page Imaging to Optimise Stent Deployment to Imaging to optimise stent deployment)
Advantages and disadvantages of different intracoronary imaging and haemodynamic modalities[1].
Fractional flow reserve (FFR), intravascular ultrasound (IVUS) and optical coherence tomography (OCT) have different roles in assessing different coronary segments.
Definitions[2]
- Malapposition: occurs when a stent (or portion of a stent) does not make contact with the vessel wall
- Under expansion: occurs when the stent (or a portion of the stent) is not at nominal diameter
- Under deployment is an imprecise term and should not be used.
Some mechanical causes of stent thrombosis identified on OCT.[3]
Causes of stent thrombosis[4]
- In cases of stent thrombosis, intravascular imaging with IVUS or OCT should be performed after initial aspiration or PCI to restore flow.
- Possible mechanical causes of stent thrombosis include:
- Malapposition
- Underexpansion
- Protrusion
- Edge dissection
- Factors associated with stent thrombosis in the HORIZONS-AMI Trial[5]:
- Under expansion (CSA < 5 mm2)
- Protrusion
- Dissection
- Malapposition was not associated with stent thrombosis.
- IVUS guided stent placement compared to no IVUS is associated with less stent thrombosis[6]
