Aim
Appropriate stent expansion is an important predictor of the long-term procedural success. The low opacity of current stents is a major obstacle in imaging their silhouette. Postdeployment image enhancement may assist clinicians in identifying suboptimal expansion and confirming proper stent deployment. The study aim was to evaluate the performance of a stent-enhancement tool in the catheterization lab and its clinical implications.\
Methods and results
The study group consisted of 55 patients (age 65±7 years; 81.8% men) undergoing coronary intervention with a stent in our catheterization lab. The novel StentOptimizer system (Paieon Medical, Israel) was used for stent enhancement. After the stent was implanted, its diameter was measured along its length using dedicated a software. Postdeployment balloon inflation was performed at operator discretion and assisted by the enhanced stent images. A total of 58 stents were evaluated in real time. The success rate of enhancement was 79.3%. The most common predictor of stent enhancement failure was the presence of chest metal struts after sternotomy (75% of failures). Suboptimal stent expansion (below 90% of the designated diameter size in any part of the stent) was detected in 76.1% of stent enhancements, and further balloon inflation was performed in 94.3% of these cases. More than two balloon inflations were performed in 28.6% of cases. Stent underexpansion was more common on the middle part (45.7%) than on the proximal or distal parts (24.3% and 28.6%, accordingly; P <.01).
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