A novel method of coronary stent sizing using intravascular ultrasound: Safety and clinical outcomes

The use of intravascular ultrasound (IVUS) in guiding coronary stenting has increased in recent years. The feasibility, safety and clinical outcomes of a novel method of sizing coronary stents using IVUS have not been established. The main end points of the current study are the incidence of acute and short-term complications, and the need for target vessel revascularization at six months.

Eighty-six patients underwent coronary stenting using IVUS imaging during the procedure. The optimal size of the stents was determined by using a novel method (the 'aggressive IVUS method'), ie, measuring the media-to-media dimensions of the coronary vessels at the site of the lesions using IVUS. A six-month follow-up chart review was performed following the initial stenting.

At six months, there were two noncardiac deaths in the group. There were no acute, subacute or late stent thromboses. Target vessel revascularization and major adverse cardiac event rates remained low - at 5.8% and 9.3%, respectively. The mean (± SD) IVUS-derived coronary stent size (3.89±0.98 mm) using the aggressive IVUS method was significantly different from the mean IVUS-derived coronary stent size (3.46±0.96 mm) using the 'traditional IVUS method'.

Aggressive sizing of the coronary stents by IVUS guidance is feasible and safe, and is associated with a favourable clinical outcome.