Balloon to artery ratio, not inflation pressure, correlates with adequate stent deployment: Size is more important than pressure

Kenichi Fujise, Peter A. Yhip, H. Vernon Anderson, George Schroth, Oscar Rosales, Richard W. Smalling

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

To investigate the relative importance of balloon to artery ratio (BAR) and poststent inflation pressure (IP), we retrospectively analyzed the 1VUS (intravascular ultrasound) data available for patients (n = 30) who underwent coronary stent implantations (n = 31) between May 1993 and April 1996 under various stent deployment strategies. Choice for sizing of the postdilatation balloon varied widely with BAR ranging from 0.75 to 1.34 (mean = 1.07 ± 0.14). IP also varied profoundly from 4 to 22 arm (mean = 14.7 ± 3.7 arms). Although there was no uncovered dissection or subintimal hemorrhage by IVUS, the adequacy of the stent deployment as assessed by relative stent expansion (RSE) varied significantly from 44.0% (very poor deployment) to 141.7% (overstretching of the arterial segment). Strikingly, BAR, not IP, correlated significantly with RSE (correlation coefficient [CC] of BAR = 0.77, P < 0.0001; CC of IP = 0.13, P > 0.5; stepwise linear regression analysis). No stent postdilated by a balloon with a BAR of ≤ 1.0 achieved a RSE of 100%, while BARs ≥ 1.2 uniformly resulted in RSEs ≥ 100%. In contrast, despite postdilation 1P of ≥ 15 atm, only 6 (33.3%) of 18 stents achieved RSE > 100%. Moreover, high RSEs were obtained by IP as low as 8 atms. Thus, BAR was much more strongly correlated with RSE, an index of optimal stent deployment, while IP was not correlated with RSE. These data suggest that BAR may be more important than IP for maximal stent implantation in the majority of patients. However, further larger scale, prospective studies are required to determine the importance of BAR versus IP to achieve optimal stent deployment.

Original languageEnglish (US)
Pages (from-to)223-229
Number of pages7
JournalJournal of Interventional Cardiology
Volume13
Issue number4
StatePublished - 2000
Externally publishedYes

Fingerprint

Economic Inflation
Stents
Arteries
Pressure
Dissection
Linear Models

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Balloon to artery ratio, not inflation pressure, correlates with adequate stent deployment : Size is more important than pressure. / Fujise, Kenichi; Yhip, Peter A.; Vernon Anderson, H.; Schroth, George; Rosales, Oscar; Smalling, Richard W.

In: Journal of Interventional Cardiology, Vol. 13, No. 4, 2000, p. 223-229.

Research output: Contribution to journalArticle

Fujise, Kenichi ; Yhip, Peter A. ; Vernon Anderson, H. ; Schroth, George ; Rosales, Oscar ; Smalling, Richard W. / Balloon to artery ratio, not inflation pressure, correlates with adequate stent deployment : Size is more important than pressure. In: Journal of Interventional Cardiology. 2000 ; Vol. 13, No. 4. pp. 223-229.
@article{b1a2c13485694484bdb823bfb82c1693,
title = "Balloon to artery ratio, not inflation pressure, correlates with adequate stent deployment: Size is more important than pressure",
abstract = "To investigate the relative importance of balloon to artery ratio (BAR) and poststent inflation pressure (IP), we retrospectively analyzed the 1VUS (intravascular ultrasound) data available for patients (n = 30) who underwent coronary stent implantations (n = 31) between May 1993 and April 1996 under various stent deployment strategies. Choice for sizing of the postdilatation balloon varied widely with BAR ranging from 0.75 to 1.34 (mean = 1.07 ± 0.14). IP also varied profoundly from 4 to 22 arm (mean = 14.7 ± 3.7 arms). Although there was no uncovered dissection or subintimal hemorrhage by IVUS, the adequacy of the stent deployment as assessed by relative stent expansion (RSE) varied significantly from 44.0{\%} (very poor deployment) to 141.7{\%} (overstretching of the arterial segment). Strikingly, BAR, not IP, correlated significantly with RSE (correlation coefficient [CC] of BAR = 0.77, P < 0.0001; CC of IP = 0.13, P > 0.5; stepwise linear regression analysis). No stent postdilated by a balloon with a BAR of ≤ 1.0 achieved a RSE of 100{\%}, while BARs ≥ 1.2 uniformly resulted in RSEs ≥ 100{\%}. In contrast, despite postdilation 1P of ≥ 15 atm, only 6 (33.3{\%}) of 18 stents achieved RSE > 100{\%}. Moreover, high RSEs were obtained by IP as low as 8 atms. Thus, BAR was much more strongly correlated with RSE, an index of optimal stent deployment, while IP was not correlated with RSE. These data suggest that BAR may be more important than IP for maximal stent implantation in the majority of patients. However, further larger scale, prospective studies are required to determine the importance of BAR versus IP to achieve optimal stent deployment.",
author = "Kenichi Fujise and Yhip, {Peter A.} and {Vernon Anderson}, H. and George Schroth and Oscar Rosales and Smalling, {Richard W.}",
year = "2000",
language = "English (US)",
volume = "13",
pages = "223--229",
journal = "Journal of Interventional Cardiology",
issn = "0896-4327",
publisher = "Wiley-Blackwell",
number = "4",

}

TY - JOUR

T1 - Balloon to artery ratio, not inflation pressure, correlates with adequate stent deployment

T2 - Size is more important than pressure

AU - Fujise, Kenichi

AU - Yhip, Peter A.

AU - Vernon Anderson, H.

AU - Schroth, George

AU - Rosales, Oscar

AU - Smalling, Richard W.

PY - 2000

Y1 - 2000

N2 - To investigate the relative importance of balloon to artery ratio (BAR) and poststent inflation pressure (IP), we retrospectively analyzed the 1VUS (intravascular ultrasound) data available for patients (n = 30) who underwent coronary stent implantations (n = 31) between May 1993 and April 1996 under various stent deployment strategies. Choice for sizing of the postdilatation balloon varied widely with BAR ranging from 0.75 to 1.34 (mean = 1.07 ± 0.14). IP also varied profoundly from 4 to 22 arm (mean = 14.7 ± 3.7 arms). Although there was no uncovered dissection or subintimal hemorrhage by IVUS, the adequacy of the stent deployment as assessed by relative stent expansion (RSE) varied significantly from 44.0% (very poor deployment) to 141.7% (overstretching of the arterial segment). Strikingly, BAR, not IP, correlated significantly with RSE (correlation coefficient [CC] of BAR = 0.77, P < 0.0001; CC of IP = 0.13, P > 0.5; stepwise linear regression analysis). No stent postdilated by a balloon with a BAR of ≤ 1.0 achieved a RSE of 100%, while BARs ≥ 1.2 uniformly resulted in RSEs ≥ 100%. In contrast, despite postdilation 1P of ≥ 15 atm, only 6 (33.3%) of 18 stents achieved RSE > 100%. Moreover, high RSEs were obtained by IP as low as 8 atms. Thus, BAR was much more strongly correlated with RSE, an index of optimal stent deployment, while IP was not correlated with RSE. These data suggest that BAR may be more important than IP for maximal stent implantation in the majority of patients. However, further larger scale, prospective studies are required to determine the importance of BAR versus IP to achieve optimal stent deployment.

AB - To investigate the relative importance of balloon to artery ratio (BAR) and poststent inflation pressure (IP), we retrospectively analyzed the 1VUS (intravascular ultrasound) data available for patients (n = 30) who underwent coronary stent implantations (n = 31) between May 1993 and April 1996 under various stent deployment strategies. Choice for sizing of the postdilatation balloon varied widely with BAR ranging from 0.75 to 1.34 (mean = 1.07 ± 0.14). IP also varied profoundly from 4 to 22 arm (mean = 14.7 ± 3.7 arms). Although there was no uncovered dissection or subintimal hemorrhage by IVUS, the adequacy of the stent deployment as assessed by relative stent expansion (RSE) varied significantly from 44.0% (very poor deployment) to 141.7% (overstretching of the arterial segment). Strikingly, BAR, not IP, correlated significantly with RSE (correlation coefficient [CC] of BAR = 0.77, P < 0.0001; CC of IP = 0.13, P > 0.5; stepwise linear regression analysis). No stent postdilated by a balloon with a BAR of ≤ 1.0 achieved a RSE of 100%, while BARs ≥ 1.2 uniformly resulted in RSEs ≥ 100%. In contrast, despite postdilation 1P of ≥ 15 atm, only 6 (33.3%) of 18 stents achieved RSE > 100%. Moreover, high RSEs were obtained by IP as low as 8 atms. Thus, BAR was much more strongly correlated with RSE, an index of optimal stent deployment, while IP was not correlated with RSE. These data suggest that BAR may be more important than IP for maximal stent implantation in the majority of patients. However, further larger scale, prospective studies are required to determine the importance of BAR versus IP to achieve optimal stent deployment.

UR - http://www.scopus.com/inward/record.url?scp=0033816548&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0033816548&partnerID=8YFLogxK

M3 - Article

AN - SCOPUS:0033816548

VL - 13

SP - 223

EP - 229

JO - Journal of Interventional Cardiology

JF - Journal of Interventional Cardiology

SN - 0896-4327

IS - 4

ER -