摘要
Angiographic studies show higher restenosis rates in long lesions covered with multiple stents. To understand this process,we compared serial [post intervention and follow up (FU,6±3 months)] intravascular ultrasound (IVUS) studies in 155 various stents implanted into 65 native de novo lesions (>20?mm). Lumen and stent areas (2?mm) were measured; plaque (stent lumen) area,late lumen loss and tissue growth were calculated for the edges, bodys, and connection points (CP) of the stents. Two types of CP were identified: overlapping (OVL) and non overlapping (NOVL). The lumen areas at CP after stent were smaller than those at the bodys or edges because of smaller stent area (OVL) and prolapse of tissue through the sites between the stents (NOVL). Post stent area10.6±2.79.5±2.59.0±2.89.1±3.0<0.0?001FU stent area9.8±3.09.4±3.18.8±3.68.9±3.50.0029.8±3.09.4±3.18.8±3.68.9±3.50.0029.4±3.18.8±3.68.9±3.50.0028.8±3.68.9±3.50.0028.9±3.50.0020.0020.00210.3±2.79.4±3.38.5±4.18.7±3.7<0.0?001FU lumen area7.1±3.66.6±3.45.5±3.75.8±4.2<0.0?001Post plaque area0.0±0.30.0±0.00.0±0.00.6±1.0<0.0?001FU plaque area3.0±2.13.2±2.03.3±2.43.4±2.30.002Late lumen loss3.2±2.22.8±2.13.0±2.73.2±2.7NSTissue growth2.8±2.62.7±2.42.8±2.52.9±2.6NS Serial IVUS imaging shows that restenosis at the connection point is the result of smaller initial lumen (OVL and NOVL) and tissue prolapse (NOVL) and is not due to an increased neointimal accumulation. New design of long stent may reduce stent restenosis in long lesions.
Angiographic studies show higher restenosis rates in long lesions covered with multiple stents. To understand this process,we compared serial [post intervention and follow up (FU,6±3 months)] intravascular ultrasound (IVUS) studies in 155 various stents implanted into 65 native de novo lesions (>20?mm). Lumen and stent areas (2?mm) were measured; plaque (stent lumen) area,late lumen loss and tissue growth were calculated for the edges, bodys, and connection points (CP) of the stents. Two types of CP were identified: overlapping (OVL) and non overlapping (NOVL). The lumen areas at CP after stent were smaller than those at the bodys or edges because of smaller stent area (OVL) and prolapse of tissue through the sites between the stents (NOVL). Post stent area10.6±2.79.5±2.59.0±2.89.1±3.0<0.0?001FU stent area9.8±3.09.4±3.18.8±3.68.9±3.50.0029.8±3.09.4±3.18.8±3.68.9±3.50.0029.4±3.18.8±3.68.9±3.50.0028.8±3.68.9±3.50.0028.9±3.50.0020.0020.00210.3±2.79.4±3.38.5±4.18.7±3.7<0.0?001FU lumen area7.1±3.66.6±3.45.5±3.75.8±4.2<0.0?001Post plaque area0.0±0.30.0±0.00.0±0.00.6±1.0<0.0?001FU plaque area3.0±2.13.2±2.03.3±2.43.4±2.30.002Late lumen loss3.2±2.22.8±2.13.0±2.73.2±2.7NSTissue growth2.8±2.62.7±2.42.8±2.52.9±2.6NS Serial IVUS imaging shows that restenosis at the connection point is the result of smaller initial lumen (OVL and NOVL) and tissue prolapse (NOVL) and is not due to an increased neointimal accumulation. New design of long stent may reduce stent restenosis in long lesions.
