Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Critical Care Medicine

Stent underexpansion is a major risk factor for in stent restenosis and acute in stent thrombosis. Intravascular ultrasound (IVUS) is the gold standard for detection of stent underexpansion. Stent boost (SB) is a recently developed technique that allows an improved angiographic visualization of the stent. To compare stent expansion parameters by IVUS, SB enhancement and QCA and to evaluate the efficiency of SB guiding the stent postdilatation. From June 2013 to August 2014, 33 stents (30 patients) were evaluated after eclective PCI using QCA, SB enhancement and IVUS. Optimization of stent deployment of inadequately expanded stents using balloon postdilatation was done then post dilatation reassessment using the previous 3 modalities. The maximal SD measured by IVUS and SB was (3.45 ± 0.62 vs 3.55 ± 0.56, p 0.53) respectively with correlation (p < 0.0001 and r 0.74). the minimal SD measured by IVUS and SB was (2.77 ± 0.53 vs 2.58 ± 0.56, p 0.07) respectively with correlation (p < 0.0001 and r 0.68). The maximal SD measured by IVUS and QCA (3.45 ± 0.62 vs 2.97 ± 0.59, p 0.009) respectively with correlation (p < 0.0001 and r 0.69). The minimal SD measured by IVUS and QCA (2.77 ± 0.53 vs1.88 ± 0.60, p 0.001) respectively with correlation (p < 0.0001 and r 0.63). The maximal SD measured by SB and QCA was (3.55 ± 0.56 vs 2.97 ± 0.59, p 0.001) respectively with correlation (p < 0.0001and r 0.61). The minimal SD measured by SB and QCA was (2.58 ± 0.56 vs 1.88 ± 0.60, p 0.001) respectively with correlation (p 0.003 and r 0.49). the postdilatation stent diameters obtained by QCA, SB and IVUS were significantly higher than poststenting diameters

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