ABSTRACT
In a four-month period of enrolment in RESEARCH, 68 consecutive patients underwent SES implantation and further post-dilatation with balloons >1 mm larger than the stent nominal size and comprise the present study population. Around 15% of the patients had diabetes mellitus, and 56% multivessel coronary disease (Table 17.1). Acute myocardial infarction was the presentation syndrome in 23.5%. Overall, 75 lesions were treated with 101 sirolimuseluting stents, with an average stent length per lesion of 26.9±18.0 mm. Among the lesions, 7 (9.3%) were in the left main, and 9 (12%) in a saphenous vein graft. Chronic total occlusions (>3 months) accounted for 24% of the procedures. Nominal stent diameter was 3.0 mm in 98 cases, 2.75 mm in 2, and 2.5 mm in 1. Further stent post-dilatation was performed with a 4.0 mm balloon in 70 lesions, and with 4.5 mm balloon in the remaining 5. Average inflation pressure was 15.9±3.6 atm. Nominal balloon to artery ratio was 1.31±0.29. IVUS was used in 21 patients (30.8%). In 85.3% of the cases, the SES was implanted to treat a de novo lesion, in 9.3% to treat in-stent restenosis, and in 4% to treat a guiding catheter-induced vessel dissection
(Table 17.2). Glycoprotein IIb/IIIa inhibitors were used in 38.2% of the patients. The procedure was successful in 67 patients (98.5%). One patient developed diffuse distal vessel dissection after post-dilatation of the 3 × 18 mm SES with a 4 × 15 mm balloon, inflated up to 12 atmospheres, and underwent successful emergency CABG.
