관동맥내 Stent 삽입술시 고압력 확장술의 유용성에 대한 재평가

초록

Background and Objectives：To reduce the subacute stent thrombosis, the use of high pressure final balloon dilatations and confirmation of adequate stent expansion by intravascular ultrasound has been recommended. The purpose of this study is to compare incidence of stent thrombosis and major cardiac events (MACE) between high and moderate pressure balloon technique without using intravascular ultrasound (IVUS) guidance. Materials and Methods：We prospectively studied 147 patients (110 males & 37 females, mean； 56.9±9.9 years, 154 lesions) who were deployed intracoronary stents with the use of conventional technique except IVUS guidance. According to inflation pressure, patients were divided into two groups；G1 (moderate pressure group, maximum inflation balloon pressure <14ATM, 77 lesion) & G2 (high pressure group, maximum inflation balloon pressure ≥14ATM, 77 lesions). We investigated the incidence of stent thrombosis and MACE between two groups during the 10 month follow up examination. Results：1) The mean inflation presure is different between two groups by definition (G1：G2 10.2±1.8；15.2±1.3 ATM p<0.001). 2) The stenotic lesion lengths of the group of patients treated with the moderate pressure techique were longer than those treated under the high pressure technique (G1：G2 19.8±7.1 mm；16.3±4.1 mm p＝0.002). 3) There were no significant differences between the moderate pressure group and the high pressure group during the 10 month follow-up examination in terms of MACE〔early event (0-14D) -subacute thrombosis G1：G2 0：0 death G1；G2 1：1/late events (15D-10M) -repeat revascularization：G1；G2 8；7, CABG G1；G2 1；0, Q.M.I G1；G2 1；0〕. Conclusion：On selected patients, it is possible to consider moderate pressure technique as an other option for coronary stenting.

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