Aims: The aim of this study was to assess the expansion capacity of
current commercially available Drug Eluting Stents (DES) with nominal
diameters of 3.5-4.0mm in patients with Left Main disease.
Materials and Methods: This study was conducted on 50
Patients who underwent percutaneous coronary intervention
(PCI)for Left Main disease at Benha university hospitals and National
Heart Institute. PCI was done with Drug Eluting Stents
(DES) with large diameters of 3.5-4mm and post dilatation was
done with non-compliant (NC) balloons with diameters of 4.5-
5mm. Intravascular ultrasound (IVUS) was used to measure
maximal stent diameter and area.
Results: Three commercially available DESs were used in our
study; XIENCE Xpeditionᵀᴹ, Ultimasterᵀᴹ and Onyxᵀᴹ. Maximal stent
diameter was 4.5±0.3mm and diameter expansion index was
0.96±0.05. Maximal stent area was 14.67±2.06mm² and area expansion
index was 0.86±0.07mm². On IVUS images, significantly
more calcification< 90 ̊ was detected in the group with expansion
index ˂ 0.85 (68.4 percent versus 25.8%, P=0.003) compared
to the group with expansion index >0.85. We found that DESs
with diameters of 3.5-4.0mm can be expanded up to diameter of
5.3mm after post-dilation. No complications were reported in the
studied patients, including perforation or stent fracture.
Conclusion: Current DESs with nominal diameters of 3.5-4.0mm
can be safely and effectively over-expanded to reach the predicted
diameters in the left main, but the presence of calcification
>90 may affect the achievement of the predicted area. |
