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Ultrasound Useful Tool After Stent Deployment

Virtual Histology intravascular ultrasound can predict distal embolization in ST-segment elevation myocardial infarction patients

WEDNESDAY, Oct. 17 (HealthDay News) -- In patients with ST-segment elevation myocardial infarction, Virtual Histology intravascular ultrasound is a useful means to predict distal embolization after the deployment of a stent, according to a report published in the Oct. 23 issue of the Journal of the American College of Cardiology.

Ren Kawaguchi, M.D., of the Gunma Prefectural Cardiovascular Center in Gunma, Japan, and colleagues conducted a study of 71 patients with ST-segment elevation myocardial infarction who underwent percutaneous coronary intervention within 12 hours of symptom onset.

Intravascular ultrasound was performed on the affected vessel after the lesion was crossed with a guidewire and thrombectomy was performed with an aspiration catheter. The stent was then deployed without embolic protection. Distal embolization was evaluated using ST-segment re-elevation, and was observed in 11 patients. This group had significantly higher necrotic core volumes than those who did not have ST-segment re-elevation; both groups had similar total plaque volumes.

"The necrotic core volume that was best predictive for ST-segment re-elevation was 33.4 mm3, with a sensitivity of 81.7 percent and a specificity of 63.3 percent," the authors write. "Virtual Histology intravascular ultrasound is a useful means of predicting the risk of distal embolization after primary stent deployment in patients with ST-segment elevation myocardial infarction," the authors conclude.

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