Optimal final lumen area and predictors of XXXX revascularization after stent implantation in small coronary arteries.

@entity1 @entity6 @entity75 @entity5642 @entity583
Despite similar early clinical events, @entity1 who undergo treatment of small vessels are at an increased risk for @entity75 revascularization (TLR) after coronary artery stenting. We sought to determine predictors of TLR after stent implantation in small coronary arteries. We identified 423 consecutive @entity1 who underwent @entity5642 ( @entity5642 )-guided small vessel stenting procedures in 465 coronary lesions with an angiographic reference vessel diameter of <2.75 mm. @entity1 were divided into 2 groups based on a final @entity5642 lumen area of < or =6.0 mm2 (n=345 lesions, group I) and >6.0 mm2 (n=115, group II). Baseline @entity1 characteristics and in-hospital outcomes were similar between the 2 groups, except for a higher rate of @entity75 in group I and bifurcation lesions in group II. Group I had higher TLR rates at 1 year compared with group II @entity1 (39% vs 26%, p = 0.02). The TLR rate appeared to decrease with greater stent expansion, especially at >90% of the reference vessel area, as assessed by @entity5642 . By multivariate analysis, an @entity5642 final stent area of < or =6 mm2, @entity6 , absence of prior @entity583 , and history of intervention were independent predictors of 1-year TLR in this population. Final stent area of >6.0 mm2 and greater stent expansion were associated with a decrease in TLR. Therefore, there does not appear to be any "downside" to aggressive stent implantation strategies in small vessels. In contrast, @entity5642 allows maximization of final lumen dimensions to minimize clinical restenosis.
