Intracoronary stent implantation under intracoronary ultrasound guidance with aspirin and ticlopidine therapy

Objective To observe the immediate angiographic and intravascular ultrasoun d (IVUS) results and their effects on one month clinical outcomes in forty- one patients who submitted to coronary stent deployment with IVUS guidance. Methods All patients were allocated to coronary stent implantation with hig h inflation pressure. After good angiographic results (< 20% residual steno sis), all patients underwent IVUS and higher-pressure dilatation would be n ecessary if criteria for optimal coronary stent implantation were not met. The optimal criterion of IVUS for stent implantation was the ratio of intra stent lumen cross-sectional area to the average of the proximal and distal reference lumen cross-sectional areas <greater than or equal to> 80%. All p atients had aspirin and ticlopidine therapy on the day of angioplasty and d uring the one month follow-up period. Results Optimal criteria of IVUS were obtained without any further intraste nt dilatation in twenty-five patients but intrastent higher-pressure dilata tion was performed in fourteen patients whose ultrasound results did not re ach the criteria. In these patients, we increased the minimal intrastent lu men area 25.7% (P < 0.05). Thirty-five patients (90%) had good minimal intr astent lumen area of IVUS. There were no deaths, myocardial infarction, acu te stent thrombosis or need for revascularization during the study and the one month follow-up. Conclusions Intracoronary stent deployment under IVUS guidance, including c ombining aspirin and ticlopidine therapy, had beneficial ultrasound results and good clinical outcomes after one month follow-up.