Coronary Artery DiseasesCoronary wallstents show significant late, postprocedural expansion despite implantation with adjunct high-pressure balloon inflations
Section snippets
Patient group
The study group consisted of 15 patients (12 men and 3 women, aged 61 ± 9 years) with symptomatic 1-vessel (n = 9) or 2-vessel disease (n = 6), who had Magic Wallstents (n = 15) implanted. All lesions were nonostial and located in right coronary arteries. The study was approved by the medical ethical committee of the Erasmus University Hospital, Rotterdam; all patients provided written informed consent.
Intervention procedures
All patients received 250 mg of aspirin and 10,000 U of heparin intravenously, and subsequent
Procedural details
All 15 Wallstents were successfully deployed. The stents were oversized by 1.6 ± 0.5 mm relative to the maximum lumen diameter. Adjunct balloon dilatation was performed using low-compliance balloon catheters with a maximum diameter of 4.0 ± 0.6 mm at an inflation pressure of 16 ± 2 atm. The balloon-to-artery ratio was 1.1 ± 0.1 using the postinterventional reference diameter as a reference.
Quantitative coronary angiography before and after stenting
During the intervention, overall the minimal lumen diameter increased from 1.0 ± 0.5 to 3.1 ± 0.4 mm (p
Discussion
The characteristic design of the Wallstent accounts for the self-expandable feature of this stent.1, 2, 15, 16, 17, 18 Initially, the self-expanding force of the Wallstent was thought to be sufficient for further gradual expansion after stent delivery. However, adjunct balloon dilatations were required to achieve stent dimensions that were sufficiently large to minimize the rate of subacute stent thrombosis. Recently, high-pressure balloon inflations after Wallstent delivery have been suggested,
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Current address: Department of Cardiology, University Hospital Essen, Hufelandstrasse 55, D45122 Essen, Germany.