Intravascular Ultrasound Use in Stent Placement May Prevent Thrombosis


WASHINGTON — The use of intravascular ultrasound to guide the placement of drug-eluting stents may help to prevent stent thrombosis, according to findings from a review of a large database of lesions.

Lack of intravascular ultrasound (IVUS) guidance was the only significant independent predictor of stent thrombosis in a series of 5,066 native and coronary bypass graft lesions treated with the Cypher sirolimus-eluting stent or the Taxus paclitaxel-eluting stent since April 2003, Dr. Probal Roy reported during a poster session at a symposium jointly sponsored by the Washington Hospital Center and the Cardiovascular Research Institute.

The Cypher stent was approved by the Food and Drug Administration in that month, and the Taxus stent was approved in March 2004.

A total of 62 of these stented lesions presented with stent thrombosis within 1 year of their initial implantation, according to Dr. Roy of the division of cardiology at the Washington Hospital Center.

Lesions for which IVUS was used to guide drug-eluting stent placement were 58% less likely to develop stent thrombosis than were those for which IVUS was not used, according to a multivariate logistic regression analysis.

The investigators defined stent thrombosis as any partial or complete stent occlusion with or without the presence of thrombosis on angiography or autopsy.

“The use of IVUS to ensure excellent stent expansion and apposition should be considered during [drug-eluting stent] implantation in an attempt to prevent stent thrombosis,” the investigators suggested.

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