European Bifurcation Club 2018 – EBC 2018 – Brussels, Belgium

How IVUS imaging can reduce the number and length of stent?

Author: Akiko Maehara Columbia University, Cardiovascular Research Foundation, New York

TAKE HOME MESSAGES

1. IVUS can inform you appropriate landing zone of stent. ≈50% of plaque burden is recommended.
2. The presence of calcified lesion, attenuated plaque (lipidic plaque), and overstretch at landing zone predict stent edge dissection.
3. When dissection occur, long (>3mm), large (>60°), deep (>=media), and small lumen (<5mm2) cause edge restenosis.
4. IVUS guidance did not decrease the actual stent length compared to PCI without IVUS by appropriate coverage, and reduced future events.
5. Side branch of bifurcation lesions are usually negative remodeling (~70- 80%) and cause carina shift after cross-over stenting.

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