Long-term Outcomes of Minor Dissection at the Edge of Coronary Stents Detected with Intravascular Ultrasound

ABSTRACT

BACKGROUND: The impacts of minor non-flow limiting dissections at the edge of stents on the late clinical outcomes are unknown. Therefore, we evaluated the influences of minor edge dissections on late angiographic in-stent restenosis. SUBJECTS & METHODS: Intravascular ultrasound (IVUS) guided single coronary stenting was successfully performed in 390 consecutive patients with 420 native coronary lesions. Six-month follow-up angiogram was performed in 327 patients (83.9%) with 348 lesions (82.9%). RESULTS: Proximal or distal minor edge dissections were observed in 67 of 348 lesions (19.3%) (proximal in 26 lesions, distal in 37 and both in 4). In distal reference segments, lumen areas and diameters were significantly smaller in the lesions with minor edge dissection (p=.037 and 0.025, respectively). The overall angiographic restenosis rate was 26.2% (91/ 348); 29.9% (20/67) in the lesions with minor edge dissections vs. 25.3% (71/281) in the lesions without minor edge dissections (p=.540). All minor dissections disappeared and were completely healed at follow-up IVUS study. CONCLUSION: Minor non-flow limiting dissections at the edge of stents might not be associated with the development of late angiographic in-stent restenosis.