STATE-OF-THE-ART PAPER
Intravascular Ultrasound in the Drug-Eluting Stent Era
Gary S. Mintz, MD*,a,* and
Neil J. Weissman, MD ,b
* Cardiovascular Research Foundation, New York, New York
Washington Hospital Center, Washington, DC.
Manuscript received January 12, 2006;
revised manuscript received March 15, 2006,
accepted April 4, 2006.
* Reprint requests and correspondence: Dr. Gary S. Mintz, Cardiovascular Research Foundation, 611 Pennsylvania Avenue, SE #386, Washington, DC 20003. (Email: gsm18439{at}aol.com).
Intravascular ultrasound (IVUS) has become an indispensable part of all drug-eluting stent (DES) studies; findings must be put into context with the IVUS findings in bare metal stents. Unfortunately, there is not yet a complete picture of either the Cypher (Cordis, Miami, Florida) or the Taxus (Boston Scientific, Maple Grove, Minnesota) stent (the two U.S. Food and Drug Administration-approved devices). Intimal hyperplasia volume in DES is reduced to <15% of stent volume, but stent underexpansion continues to be a consistent finding in DES failures (restenosis and thrombosis). The utility of IVUS to assure adequate stent expansion may be more important whenever there are clinical risk factors for DES failure.
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Abbreviations and Acronyms
| | BMS = bare-metal stent | | CSA = cross-sectional area | | EEM = external elastic membrane | | IH = intimal hyperplasia | | ISR = in-stent restenosis | | IVUS = intravascular ultrasound | | LAD = left anterior descending | | LMCA = left main coronary artery | | LSM = late stent malapposition | | MSA = minimum stent CSA | | P&M = plaque and media |
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