Impact of postprocedure minimum stent area on long-term results following abciximab-coated stent implantation: An intravascular ultrasound analysis

Background: Smaller postprocedural minimum stent areas (MSA) measured by intravascular ultrasound (IVUS) have been associated with higher restenosis rates. Methods: This was a single-center, prospective, randomized trial and we assessed the predictive value of MSA for long-term patency and the incidence and extent of incomplete stent apposition (ISA) following abciximab-coated stent (n = 69) compared to bare metal stent (BMS) implantation (n = 69). All patients underwent IVUS follow-up at 6 months. Results: At follow-up coronary angiogram, the restenosis rate and late loss were 12%, 0.30 ± 0.24 mm in abciximab-coated stent group and 29%, 0.68 ± 0.36 mm in BMS group (p = 0.011, 0.010, respectively). At follow-up IVUS, intrastent lumen area was significantly larger and intrastent neointimal hyperplasia area was significantly smaller in abciximab-coated stent group than those in BMS group (5.9 ± 1.6 mm² vs. 4.5 ± 1.7 mm², p = 0.001, and 1.9 ± 1.5 mm² vs. 3.3 ± 1.9 mm², p < 0.001, respectively). Target lesion revascularization occurred in 9%, 0%, and 0% in abciximab-coated stent group and 19%, 4%, and 1% in BMS group in lesions with a MSA < 6.0 mm², from 6 to 7.5 mm², and > 7.5 mm², respectively. Late-acquired ISA at follow-up was observed in 7 patients and there was no difference in the incidence of ISA between both groups [abciximab-coated stent: n = 3 (4%) vs. BMS: n = 4 (6%), p = 0.698]. Conclusion: Abciximab-coated stent reduced restenosis and had a considerably lower optimal MSA threshold compared to BMS and showed lower incidence of late-acquired ISA.