Long-term outcomes of minor dissection at the edge of stents detected with intravascular ultrasound

Coronary stenting has been accepted as a very effective treatment modality in patients with coronary artery disease.(1,2) Poststent high-pressure inflation techniques with the introduction of antiplatelet agents and use of intravascular ultrasound (IVUS) provide a marked reduction in stent thrombosis and a lower rate of late restenosis.(3-5) Therefore, aggressive dilatation with high-pressure inflation for stent deployment has usually been recommended.(5) However, edge dissections were sometimes observed as one of the complications of the aggressive stent dilatation.(6) If the plaque of edge dissection protrudes into the lumen and limits the distal coronary blood flow, it is necessary for the operators to deploy an additional stent to cover a significant dissection. However, when the edge dissection is minor and non-flow limiting, there has been controversy over deploying or not deploying an additional stent as the treatment modality. The aim of the present study was to evaluate the influences of minor edge dissections on late angiographic in-stent restenosis.