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 mm(2) vs. 4.5+/-1.7 mm(2), p=0.001, and 1.9+/-1.5 mm(2) vs. 3.3+/-1.9 mm(2), 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 mm(2), from 6 to 7.5 mm(2), and >7.5 mm(2), 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.