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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.

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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