Evaluating Coronary Stenting Result
From Ask Dr Wiki
Following coronary stent implantation, the following set of steps is one way to systematically evaluate the post-stent-deployment angiogram.
- Is there any injury to the proximal vessel from guide catheter manipulation?
- Is the stent well expanded throughout its length, or are there residual stenoses?
- Does the stented segment of the vessel appear hazy?
- Did the stent deployment compromise blood flow in any branch vessels?
- Are there any tears in the vessel such as proximal or distal edge dissection, or dye extravasation to the vessel wall or the pericardium?
- How is the flow in the coronary artery and the myocardium that it supplies?
- Is there any distal microvasculature perforation secondary to the guide wire manipulation?
In addition to the angiographic interpretation, clinical assessment is very important. Chest discomfort, arrhythmia, ischemic ECG changes, and hypotension may all result following stent deployment.