scholarly journals In vivo measurement of stent length by using intravascular ultrasound

2019 ◽  
Vol 71 (1) ◽  
Author(s):  
Magdy Algowhary ◽  
Salma Taha ◽  
Hosam Hasan-Ali ◽  
Akihiko Matsumura
Keyword(s):  
Intravascular Ultrasound ◽  
Bare Metal Stent ◽  
Edge Length ◽  
Drug Eluting Stent ◽  
Elastic Membrane ◽  
Lesion Length ◽  
In Vivo Measurement ◽  
Longitudinal View ◽  
Stent Length

Abstract Background What happens to stent length when deployed in a coronary artery? It is the aim of this study. Results Consecutive 95 balloon-expandable stents (BES) were studied by intravascular ultrasound (IVUS) imaging. The stent length was measured from the longitudinal view in two ways: (1) edge-to-edge length (E-E) measured between distal and proximal stent frames located at one IVUS quadrant and (2) area-to-area length (A-A) measured between distal and proximal stent frames located at two or more IVUS quadrants. IVUS measurements were compared with the manufacturer-stated length (M-L). The median E-E length was significantly longer than M-L, 18.76 mm [interquartile range (IQR) 15.65–23.60] versus 18.00 mm (IQR 15.00–23.00), respectively, p < 0.0001. Also, the median A-A length was significantly longer, 18.36 mm (IQR 15.19–23.47), p < 0.0001, than M-L. Moreover, the E-E length was significantly different from A-A length, p < 0.0001. Among the stent groups, the differences were significantly present in all drug-eluting stent and bare metal stent (BMS) comparisons, p < 0.0001, except the A-A length versus M-L in BMS only. By multivariate analysis, the predictors of difference in stent length were as follows: lesion length, p = 0.01; pre-intervention minimal diameter of the external elastic membrane (EEM), p = 0.03; lesions present in the left anterior descending branch, p = 0.03; and M-L, p = 0.04. Conclusions In the present study, the length of BES measured by IVUS was significantly different from the manufacturer-stated length. In addition to the manufacturer length, other important factors such as lesion length, pre-intervention diameter of EEM, and affected vessel determine the stent length.

scholarly journals Cardiac Lymphatic Dysfunction Causes Drug-Eluting Stent–Induced Coronary Hyperconstricting Responses in Pigs In Vivo

2019 ◽  
Vol 39 (4) ◽  
pp. 741-753 ◽  
Author(s):  
Hirokazu Amamizu ◽  
Yasuharu Matsumoto ◽  
Susumu Morosawa ◽  
Kazuma Ohyama ◽  
Hironori Uzuka ◽  
...  
Keyword(s):  
Experimental Studies ◽  
Lymphatic Vessels ◽  
Rho Kinase ◽  
Inflammatory Cells ◽  
Bare Metal Stent ◽  
Drug Eluting Stent ◽  
Kinase Activation ◽  
Coronary Vasomotion ◽  
Drug Eluting

Objective— We have previously demonstrated that coronary adventitial inflammation plays important roles in the pathogenesis of coronary vasomotion abnormalities, including drug-eluting stent (DES)–induced coronary hyperconstricting responses. Importantly, the adventitia also harbors lymphatic vessels, which may prevent inflammation by transporting extravasated fluid and inflammatory cells. We thus aimed to examine the roles of coronary adventitial lymphatic vessels in the pathogenesis of DES-induced coronary hyperconstricting responses in a porcine model in vivo. Approach and Results— We performed 2 experimental studies. In protocol 1, 15 pigs were divided into 3 groups with or without DES and with bare metal stent. Nonstented sites 20 mm apart from stent implantation also were examined. In the protocol 2, 12 pigs were divided into 2 groups with or without lymphatic vessels ligation followed by DES implantation at 2 weeks later (n=6 each). We performed coronary angiography 4 weeks after DES implantation, followed by immunohistological analysis. In protocol 1, the number and the caliber of lymphatic vessels were greater at only the DES edges after 4 more weeks. In protocol 2, coronary hyperconstricting responses were further enhanced in the lymphatic vessels ligation group associated with adventitial inflammation, Rho-kinase activation, and less adventitial lymphatic vessels formation. Importantly, there were significant correlations among these inflammation-related changes and enhanced coronary vasoconstricting responses. Conclusions— These results provide evidence that cardiac lymphatic vessel dysfunction plays important roles in the pathogenesis of coronary vasoconstrictive responses in pigs in vivo.

In Vivo Measurement of Regional Large Artery Compliance by Intravascular Ultrasound Under Pentobarbital Anesthesia

Angiology ◽  
1995 ◽  
Vol 46 (6) ◽  
pp. 481-488 ◽  
Author(s):  
Richard A. Wilson ◽  
Carlo Di Mario ◽  
Rob Krams ◽  
Loe Kie Soei ◽  
Li Wenguang ◽  
...  
Keyword(s):  
Intravascular Ultrasound ◽  
Large Artery ◽  
Pentobarbital Anesthesia ◽  
In Vivo Measurement

Abstract 4461: Rho-kinase Pathway Plays an Important Role in the Pathogenesis of Coronary Hyperconstricting Responses Induced by Drug-Eluting Stent

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Takashi Shiroto ◽  
Satoshi Yasuda ◽  
Ryuji Tsuburaya ◽  
Yoshitaka Ito ◽  
Hatsue Ishibashi-Ueda ◽  
...  
Keyword(s):  
Kinase Inhibitor ◽  
Rho Kinase ◽  
Bare Metal Stent ◽  
Drug Eluting Stent ◽  
Rho Kinase Inhibitor ◽  
Drug Eluting ◽  
Kinase Expression ◽  
Kinase Pathway

It has recently been reported that coronary vasoconstricting responses are enhanced at the edge of coronary segment implanted with drug-eluting stent (DES) as compared with bare-metal stent (BMS) in humans. We have previously demonstrated in animal models and humans that activation of Rho-kinase plays a key role in the molecular mechanism of coronary vasospasm. In this study, we thus examined whether Rho-kinase pathway also is involved in the DES-induced coronary hyperconstriction in vitro and in vivo. In cultured human coronary vascular smooth muscle cells, paclitaxel (10 –1000 nM, comparable tissue concentrations in humans, 24 hours) concentration-dependently up-regulated Rho-kinase expression (n=9) and increased Rho-kinase activity (10 nM, n=6). In a porcine model in vivo, DES (Taxus ™ ) and BMS (Express ™ ) were randomly implanted in the left anterior descending and circumflex coronary arteries (n=5). Four weeks after the implantation, coronary vasoconstricting responses to serotonin (5-HT, 50 and 100 μg/kg, IC) were significantly enhanced at the DES site compared with the BMS site (DES −52±4 vs. BMS −31±5%, P<0.01), and the enhanced responses were prevented by hydroxyfasudil (HF, 90 and 300 μg/kg, IC), a selective Rho-kinase inhibitor ( Figure A ). The same in vivo findings also were noted in another comparison between DES (Cypher ™ ) and BMS (Velocity ™ ) (DES −62±3% vs. BMS −41±3%, n=6, P<0.01) ( Figure B ). Histological analysis showed microthrombus formation only at the DES site. These results suggest that Rho-kinase pathway also plays an important pathogenetic role in the DES-induced coronary hyperconstricting responses.

Abstract 13701: Impact of Stent Platform on Longitudinal Stent Deformation: an in vivo 3-dimensional Optical Coherence Tomography Study

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Ryotaro Yamada ◽  
Teruyoshi Kume ◽  
Kenzo Fukuhara ◽  
Terumasa Koyama ◽  
Tomitaka Higa ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
In Vivo Studies ◽  
Drug Eluting Stent ◽  
Optical Coherence ◽  
3 Dimensional ◽  
Stent Deformation ◽  
Stent Length ◽  
Drug Eluting ◽  
Possible Cause

Introduction: Recently, longitudinal coronary stent deformation has been highlighted as a possible cause of drug-eluting stent failure. Although bench tests and in-vivo studies have demonstrated difference in longitudinal stent strength among the stents with different platforms, its clinical impact is still unknown. The aim of this study was to investigate the longitudinal deformation of the everolimus-eluting stents (EES) with different stent platforms by using 3-dimensional frequency domain optical coherence tomography (3D FD-OCT). Methods: Fifty-nine lesions treated with EES (Xience Prime (CoCr-EES): n=28, Promus element (PtCr-EES): n=31) were studied. Stent length was measured by 3D FD-OCT. Percent longitudinal stent shortening (%SS) was defined as the longitudinally shortened stent length standardized by nominal stent length. Longitudinal stent deformation was defined as %SS >10%. Results: Patients’ and procedural characteristics were similar between CoCr- and PtCr-EES. There was no difference in mean %SS between PtCr-EES and CoCr-EES (3.1±6.5 vs. 0.9±5.6%, p=0.197). However, incidence of longitudinal stent deformation was significantly higher in PtCr-EES than in CoCr-EES (16.1% vs 0%, p=0.026) (Figure). Conclusions: Incidence of longitudinal stent deformation was different between EESs with different stent platforms. Stent material, stent design and/or stent delivery balloon may affect longitudinal stent deformation.

Can intravascular ultrasound guidance modify the efficacy of drug-eluting stent over bare-metal stent in an aorto-ostial lesion?

2011 ◽  
Vol 12 (2) ◽  
pp. 105-110 ◽  
Author(s):  
Teruo Okabe ◽  
Akio Kawamura ◽  
Yuichiro Maekawa ◽  
Toshihisa Anzai ◽  
Shiro Iwanaga ◽  
...  
Keyword(s):  
Intravascular Ultrasound ◽  
Ultrasound Guidance ◽  
Bare Metal Stent ◽  
Drug Eluting Stent ◽  
Bare Metal ◽  
Metal Stent ◽  
Drug Eluting ◽  
Ostial Lesion

scholarly journals Safety and Feasibility of Intravascular Ultrasound-Guided Robotic

2021 ◽  
Author(s):  
Takumi Kimura ◽  
Yorihiko Koeda ◽  
Masaru Ishida ◽  
Shohei Yamaya ◽  
Sayaka Kikuchi ◽  
...  
Keyword(s):  
Intravascular Ultrasound ◽  
Coronary Intervention ◽  
Lesion Length ◽  
Cardiac Events ◽  
Stent Deployment ◽  
Landing Position ◽  
Adverse Cardiac Events ◽  
Percutaneous Coronary ◽  
Stent Length ◽  
Geographic Miss

Abstract PurposePrevious studies have demonstrated the benefit of intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI) for preventing longitudinal geographic miss (LGM). However, it is yet unclear whether IVUS guidance is useful for robotic PCI (R-PCI). This retrospective observational study sought to compare expected stent landing positions between IVUS and angiography.MethodsA total of 58 consecutive patients with stable angina who underwent IVUS-guided R-PCI was enrolled. The stent landing position was angiographically marked using a balloon marker before stenting followed by measurements of the expected stent length using balloon pullback. Subsequently, pre-stenting IVUS was performed to determine stent landing. All pre-PCI IVUS images were assessed for lesion length and percent plaque volume (%PV) using both IVUS and angiographic marking. LGM was defined as a residual %PV > 50% at either the distal or proximal stent edge, any stent edge dissection, and/or additional stent deployment immediately after stenting. Major adverse cardiac events were assessed at the 6-month follow-up.ResultsThe included patients, 41 of whom were male, had an average age of 67.1 ± 10.1 years. IVUS guidance had significantly longer lesion lengths compared to angiographic marking. Based on IVUS-guided stent deployment, 9 cases exhibited LGM immediately after stenting. IVUS-marked landing points had a significantly smaller %PV and significantly larger LA compared to those for angiography. No adverse cardiac events were noted during the 6-month follow-up.ConclusionIVUS-guided R-PCI was safe and may be better at preventing LGM compared to angiography-guided R-PCI.

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