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| Correlation of Vessel Tapering and Vascular Response of Proximal and Distal Edges of Sirolimus-Eluting Stents ; Serial Intravascular Ultrasound Analysis. |
| 계명대학교 동산의료원 심장내과¹ |
| 윤혁준¹ , 허승호¹ , 조윤경¹ , 박형섭¹ , 남창욱¹ , 김형섭¹ , 김윤년¹ , 김권배¹ |
Background & objective
The degree of vessel tapering can be a particular concern in coronary stenting due to increased risk of vascular injury at the distal edge.
We would like to evaluate the relationship between vascular response at the stent edge area and the degree of vessel tapering by serial intravascular ultrasound (IVUS) analysis.
Method
116 Coronary lesions (114 patients) which deployed single sirolimus eluting stent were enrolled in this study. The degree of vessel tapering was defined as tapering index (TI), that of difference between proximal and distal segment diameter, divided by the lesion length. We divided these lesions as tertiles group according to TI.
Result
Significant vessel tapering was frequently founded at left anterior descending artery and left circimflex artery compared with right coronary artery (p<0.01)
There was no significant change of plaque volume in proximal edge in all groups. However, in distal edge, 3rd TI tertiles group (most severe tapered) showed significant increase of plaque volume compared with 1st TI tertiles. (1st TI -0.15 ± 1.03 vs. 3th TI 0.36 ± 0.98mm2, p=0.023) However, this stent edge plaque progression was offset by positive vascular remodeling without luminal reduction.
Conclusion
SES implantation in severely tapered artery can be associated with increased stent distal edge plaque progression.
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