QUANTITATIVE CORONARY ANGIOGRAPHIC AND INTRAVASCULAR ULTRASOUND ASSESSMENT OF A NEW NONARTICULATED STENT - REPORT FROM THE ADVANCED CARDIOVASCULAR SYSTEMS MULTILINK STENT PILOT-STUDY

Objectives. The purpose of this study was to evaluate the safety, feas ibility, optimal deployment technique and I-year clinical outcome for the Advanced Cardiovascular Systems (ACS) Multilink stent, Background. Optimal stent deployment assessed by quantitative coronary angiograph y and intravascular ultrasound (IVUS) is associated with improved clin ical outcome. Methods. Forty-nine consecutive patients with a discrete stenosis in a native coronary artery 3 to 4 mm in diameter were treat ed with the new, balloon-expandable ACS MultiLink stent. Stent expansi on was assessed in all patients using quantitative coronary angiograph y and serial IVUS imaging after 8-, 12- and 16-atm inflations., Clinic al follow up was obtained at 30 days and 1 gear. Results. All 49 patie nts had successful placement of a Multilink stent without death, emerg ency coronary artery bypass graft surgery or Q wave myocardial infarct ion, After placement of the MultiLink stent, the minimal lumen diamete r increased from 1.24 to 2.98 mm (p < 0.001), and diameter stenosis de creased from 61% to 7% (p = 0.001), Minimal lumen cross-sectional area by NUS increased progressively after 8, 12 and 16 atm (5.6 to 6.8 to 7.4 mm(2), respectively, p < 0.001), However, only 61% of stents achie ved a lumen/reference area ratio greater than or equal to 70%. No adve rse clinical events occurred by 30 days, and by 1 year only one patien t (2.0%) required revascularization of the stented artery, Conclusions . Treatment of stenoses in native coronary arteries with the MultiLink stent is associated with a high success rate and a low incidence of a dverse events by 1 year, despite the fact that the majority of stents did not meet IVUS-defined criteria for ''optimal stenting'' derived fr om first-generation devices. (C) 1998 by the American College of Cardi ology.