J Cardiovasc Interv.  2023 Oct;2(4):243-248. 10.54912/jci.2023.0011.

Impact of Real-time Enhanced Stent Visualization in Patients Undergoing Overlapping Stent Procedures: A Pilot Study

• Thuong NN
• Kim BJ
• Ngoc TN

• KMID: 2560950
• DOI: http://doi.org/10.54912/jci.2023.0011

Abstract

Background
Complex percutaneous coronary intervention (PCI) procedures involving overlapping stents or bifurcation stenting require a lot of fluoroscopic time, which leads to high X-ray exposure for the patient as well as the medical staff. ClearStent Live is a real-time enhanced stent visualization (ESV) tool enabling a stabilized display in real time and improved visualization of stents during PCIs. It also allows a high-quality, real-time evaluation of overlapping stent deployment and assessment of integrity, apposition as well as distortion of the stent. This study is to compare the cumulative radiation dose (dose area product; DAP) in coronary stenting of coronary lesions performed with or without ClearStent Live in PCI.
Methods
This is a prospective, open-label, non-randomized study with 100 patients. The treatment group comprises 50 patients who underwent stenting supported by ClearStent Live, as compared to the control group without ClearStent Live support (with standard fluoroscopic, cineangiography imaging or ClearStent).
Results
The DAP in the ClearStent Live group was significantly lower than in the group without ClearStent Live (5,290.83 ± 2,367.07 μGym² vs. 6,499.28 ± 3,140.12 μGym² , P = 0.03). The volume of contrast used was also significantly lower in the ClearStent Live group when compared to the non-ClearStent Live group (111.80 ± 15.86 mL vs. 128.60 ± 25.72 mL, P < 0.01).
Conclusions
The study shows that PCIs for patients with 2 or more overlapping stents required less radiation dosage and volume of contrast agent when ClearStent Live was used when compared to PCIs without ClearStent Live which encourages the routine use of realtime ESV tools in overlapping stent procedures.

Keyword

Fluoroscopy; Radiation; Percutaneous coronary intervention