BACKGROUND: Percutaneous coronary intervention in small vessels (SV) is associated with poor short- and long-term outcomes, with high rates of restenosis. Previous studies have suggested that self-expanding stents can cause less vessel injury at implantation, expanding their volumes over time, and leading to larger luminal areas than those of balloon-expandable stents. The influence of these phenomena on SV remains unknown. OBJECTIVES: To assess the mechanical properties and efficacy of the novel CardioMindTM stent in comparison with the balloon-expandable Multi-Link PixelTM (Pixel) stent in the treatment of SV. METHODS: Thirteen patients with single, de novo, < 14 mm length lesions in native coronary arteries < 2.5 mm in diameter were treated with the CardioMindTM stent and compared with a historical cohort of 25 patients, with the same inclusion criteria, treated with the PixelTM stent. Intravascular ultrasound (IVUS) was performed serially after the procedure and at 7.3 ± 1.0 months of follow-up. RESULTS: Mean age was 58.1 ± 9.9 years; 60.5% were male and 39.4% were diabetic. Both stents produced similar neointimal hyperplasia (NIH) volumes (indexed NIH volume: 1.45 ± 0.46 mm³/mm for CardioMindTM versus 1.66 ± 1.02 mm³/mm for PixelTM; p = 0.48). However, the CardioMindTM stent presented a 12% expansion of its volume, leading to a lesser in-stent volumetric obstruction (31.94 ± 8.19% versus 39.90 ± 4.72%; p = 0.0005). Injury at the edges of the CardioMindTM and Multi-Link PixelTM stents were not detected. CONCLUSIONS: Serial volumetric IVUS showed that CardioMindTM and PixelTM stents produced similar volumes of neointimal tissue. However, continued expansion of CardioMindTM stent generated larger luminal volumes and lower percent in-stent volumetric obstruction. The two stents were harmless to the edge segments.
Stents; Angioplasty, transluminal, percutaneous coronary; Ultrasonography
