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Intravascular ultrasound assessment of minimum lumen area and intimal hyperplasia in in-stent restenosis after drug-eluting or bare-metal stent implantation. The Nordic Intravascular Ultrasound Study (NIVUS)

Jensen, Lisette Okkels ; Vikman, Saila ; Antonsen, Lisbeth ; Kosonen, Petteri ; Niemelä, Matti ; Christiansen, Evald Høj ; Kervinen, Kari ; Erglis, Andrejs ; Harnek, Jan LU and Kumsars, Indulis , et al. (2017) In Cardiovascular Revascularization Medicine 18(8). p.577-582
Abstract

Introduction: Drug-eluting stents (DES) reduce the risk of restenosis after percutaneous coronary intervention. The aim of the study was to evaluate, by intravascular ultrasound (IVUS), the minimum lumen area site in the stented segment and the distribution of intimal hyperplasia in patients presenting with a DES or bare-metal stent (BMS) in-stent restenosis. Methods: The “Nordic Intravascular Ultrasound Study (NIVUS)” study was conducted in Nordic and Baltic countries as a prospective multicenter registry. Two hundred nine patients (DES n = 121 and BMS n = 88) with in-stent restenosis were enrolled. Results: At the minimum lumen area site in the stented segment, the stent area (5.8 ± 2.2 mm2 vs. 7.6 ± 2.4 mm2, p... (More)

Introduction: Drug-eluting stents (DES) reduce the risk of restenosis after percutaneous coronary intervention. The aim of the study was to evaluate, by intravascular ultrasound (IVUS), the minimum lumen area site in the stented segment and the distribution of intimal hyperplasia in patients presenting with a DES or bare-metal stent (BMS) in-stent restenosis. Methods: The “Nordic Intravascular Ultrasound Study (NIVUS)” study was conducted in Nordic and Baltic countries as a prospective multicenter registry. Two hundred nine patients (DES n = 121 and BMS n = 88) with in-stent restenosis were enrolled. Results: At the minimum lumen area site in the stented segment, the stent area (5.8 ± 2.2 mm2 vs. 7.6 ± 2.4 mm2, p < 0.001) and intimal hyperplasia area (2.6 ± 2.0 mm2 vs. 5.0 ± 2.2 mm2, p < 0.001) were significantly lower in patients treated with DES compared to BMS. The percentage of stents that did not have a minimum stent area of at least 5.0 mm2 (under expansion) was higher in DES (58.7% vs. 37.7%, p = 0.008) compared to BMS. Intimal hyperplasia covered 55.4 ± 33.3% of the stent length in the DES compared to 90.7 ± 17.4% in the BMS group, p < 0.001. Focal in-stent restenosis was more often seen in DES treated patients compared to BMS treated patients (DES n = 84 (59.9%) vs. BMS n = 15 (17.0%), p < 0.001). Conclusion: Stent underexpansion was more often seen in DES than BMS in-stent restenosis. DES more often had focal in-stent restenosis with less intimal hyperplasia.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Bare-metal stent, Drug-eluting stent, In-stent restenosis, Intravascular Ultrasound
in
Cardiovascular Revascularization Medicine
volume
18
issue
8
pages
6 pages
publisher
Elsevier
external identifiers
  • scopus:85042284870
  • pmid:29066343
ISSN
1553-8389
DOI
10.1016/j.carrev.2017.05.010
language
English
LU publication?
yes
id
fd2d2ede-c943-4c8c-873c-448d260d40d0
date added to LUP
2018-03-09 10:51:55
date last changed
2024-01-14 16:35:04
@article{fd2d2ede-c943-4c8c-873c-448d260d40d0,
  abstract     = {{<p>Introduction: Drug-eluting stents (DES) reduce the risk of restenosis after percutaneous coronary intervention. The aim of the study was to evaluate, by intravascular ultrasound (IVUS), the minimum lumen area site in the stented segment and the distribution of intimal hyperplasia in patients presenting with a DES or bare-metal stent (BMS) in-stent restenosis. Methods: The “Nordic Intravascular Ultrasound Study (NIVUS)” study was conducted in Nordic and Baltic countries as a prospective multicenter registry. Two hundred nine patients (DES n = 121 and BMS n = 88) with in-stent restenosis were enrolled. Results: At the minimum lumen area site in the stented segment, the stent area (5.8 ± 2.2 mm<sup>2</sup> vs. 7.6 ± 2.4 mm<sup>2</sup>, p &lt; 0.001) and intimal hyperplasia area (2.6 ± 2.0 mm<sup>2</sup> vs. 5.0 ± 2.2 mm<sup>2</sup>, p &lt; 0.001) were significantly lower in patients treated with DES compared to BMS. The percentage of stents that did not have a minimum stent area of at least 5.0 mm<sup>2</sup> (under expansion) was higher in DES (58.7% vs. 37.7%, p = 0.008) compared to BMS. Intimal hyperplasia covered 55.4 ± 33.3% of the stent length in the DES compared to 90.7 ± 17.4% in the BMS group, p &lt; 0.001. Focal in-stent restenosis was more often seen in DES treated patients compared to BMS treated patients (DES n = 84 (59.9%) vs. BMS n = 15 (17.0%), p &lt; 0.001). Conclusion: Stent underexpansion was more often seen in DES than BMS in-stent restenosis. DES more often had focal in-stent restenosis with less intimal hyperplasia.</p>}},
  author       = {{Jensen, Lisette Okkels and Vikman, Saila and Antonsen, Lisbeth and Kosonen, Petteri and Niemelä, Matti and Christiansen, Evald Høj and Kervinen, Kari and Erglis, Andrejs and Harnek, Jan and Kumsars, Indulis and Thuesen, Leif and Niemelä, Kari}},
  issn         = {{1553-8389}},
  keywords     = {{Bare-metal stent; Drug-eluting stent; In-stent restenosis; Intravascular Ultrasound}},
  language     = {{eng}},
  month        = {{12}},
  number       = {{8}},
  pages        = {{577--582}},
  publisher    = {{Elsevier}},
  series       = {{Cardiovascular Revascularization Medicine}},
  title        = {{Intravascular ultrasound assessment of minimum lumen area and intimal hyperplasia in in-stent restenosis after drug-eluting or bare-metal stent implantation. The Nordic Intravascular Ultrasound Study (NIVUS)}},
  url          = {{http://dx.doi.org/10.1016/j.carrev.2017.05.010}},
  doi          = {{10.1016/j.carrev.2017.05.010}},
  volume       = {{18}},
  year         = {{2017}},
}