Effect Of Oversized Postdilatation Of Drug-Eluting Stents On Clinical Outcomes Of Patients With Coronary Atherosclerotic Disease

BackgroundWhen treating the long lesions and bifurcation lesions of coronary arteries,interventionists sometimes perform postdilatation of the proximal part of the stent with a balloon whose diameter is larger than that of the stent,which is called oversized postdilatation.When it is performed in a drug-eluting stent(DES),oversized postdilatation may change the configuration of the stent and reduce the support force on the lesion;moreover,it may damage the drug coating and affect the local drug concentration,which has a negative impact on the clinical outcomes of patients.This study attempts to assess the effect of oversized postdilatation of drug-eluting stents on the incidence of major adverse cardiovascular events(MACE)in patients with coronary atherosclerotic disease.MethodsIn this study,1522 patients(2514 lesions)who received implantation of one or more DESs in the Sir Run Run Shaw Hospital,Zhejiang University School of Medicine from July 2013 to June 2016 and had complete follow-up information were enrolled.The patients who had previously received PCI or CABG and those whose bifurcation lesions were treated with double-stent technique were ruled out.According to whether or not the stent is oversized postdilated,the patients were divided into the oversized postdilatation group(n=624)and the non-oversized postdilatation group(n=898).It was analyzed whether there was a significant difference between the two groups in the incidence of MACEs(death,nonfatal myocardial infarction,and target vessel revascularization).ResultsThere was no significant difference in gender,age,body mass index(BMI),current smoking,hypertension,diabetes,hyperlipidemia,previous myocardial infarction,previous stroke,family history of coronary atherosclerotic disease,clinical manifestations and preoperative LDL-cholesterol,creatinine and fasting blood glucose.The number of stents,stent length,number of lesions and number of treated vessels in the oversized postdilatation group were more than that in the non-oversized postdilatation group,with a statistically significant difference.There was no significant difference in the lesion location and the proportion of type B2 or C lesions(92.6%vs.90.5%,P=0.062).There was also no significant difference in the death(2.1%vs.1.8%,P=0.706),nonfatal myocardial infarction(4.0%vs.3.1%,P=0.394)and target vessel revascularization(5.3%vs.4.7%,P=0.631).ConclusionOversized postdilatation of drug-eluting stents does not have a significant effect on the clinical outcomes of patients.