Key result
Enhanced stent imaging guidance during percutaneous coronary intervention was significantly associated with a larger final minimal lumen diameter compared to conventional X-ray guidance (adjusted Beta 0.05, p=0.001).
Why the study?
Stent under-expansion predicts restenosis and stent thrombosis, but whether enhanced stent imaging (CLEARstent) guidance can improve stent under-expansion remains uncertain.
Does enhanced stent imaging (ESI) guidance improve post-procedural minimal lumen diameter in patients undergoing PCI for stable angina or acute coronary syndrome?
Cross-Sectional (n=241)
No
Does enhanced stent imaging (ESI) guidance improve post-procedural minimal lumen diameter in patients undergoing PCI for stable angina or acute coronary syndrome?
Mean Difference: 0.05 (95% CI 0.01–0.1)
Absolute Event Rate: 2.63% vs 2.55%
p-value: p=0.001
Enhanced stent imaging guidance during PCI is associated with improved stent expansion as measured by greater minimal lumen diameter compared to standard X-ray guidance.
ESI-guided PCI may enhance stent expansion; cross-sectional data leave open need for RCTs before practice change.
Stent under-expansion is a predictor of restenosis and stent thrombosis. It remains uncertain whether enhanced stent imaging (ESI) (CLEARstent) guidance can improve stent under-expansion. Our aim was to assess the effect of using ESI on stent under-expansion, after percutaneous coronary intervention (PCI) in a single center, cross-sectional observational study. Participants attending our cardiology clinic with stable angina or acute coronary syndrome, from March to September 2020 were recruited. A total of 164 patients who underwent post-PCI ESI (CLEARstent) were compared with 77 age- and sex-matched control patients. Post-procedural minimal lumen diameter (MLD) was calculated. The patients in the ESI-guided PCI group, had a median age of 61 (54–69 IQR 25-75) years and 76.8% (n = 126) were males. The patients in ESI-guided PCI group had a greater minimal lumen diameter compared with the X-ray guided PCI group (βeta coefficient:2.88 (95% CI:2.58–2.99) vs βeta coefficient 2.55 (95% CI 2.34–2.63), P < .001). Our finding supports the use of the ESI system to optimize stent placement as expressed by the MLD.
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Avcı et al. (2022) conducted a cross-sectional in Stable angina or acute coronary syndrome (n=241). Enhanced stent imaging (ESI) guided PCI vs. Conventional X-ray guided PCI was evaluated on Minimal lumen diameter (MLD) (Beta 0.05, 95% CI 0.01-0.10, p=0.001). Enhanced stent imaging guidance during percutaneous coronary intervention was significantly associated with a larger final minimal lumen diameter compared to conventional X-ray guidance (adjusted Beta 0.05, p=0.001).
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