Morphologic change in coronary artery stenosis with the Medtronic Wiktor(TM) Stent: Initial results from the Core Laboratory for Quantitative Angiography

The purpose of this study was to assess the early changes in stenosis geometry after implantation of the Medtronic Wiktor(TM) stent in human coronary arteries. Morphologic changes were evaluated by quantitative coronary angiography using automated edge detection. The hemodynamic significance of the morphologic changes were assessed by the calculation of the theoretical pressure drop across the dilated and stented stenosis derived from the Poiseuile and turbulent resistances assuming a coronary blood flow of either 0.5, 1, or 3 ml/sec. Fifty patients were studied before and immediately after stent implantation. The stented coronary artery was the left anterior descending artery in 26 patients, the circumflex artery in eight patients, and the right coronary artery in 16 patients. Stent implantation resulted in an additional increase in the minimal luminal cross-sectional area and minimal luminal diameter of the dilated vessel without changing the curvature of the stenosis. Furthermore, there was a significant reduction of the ''plaque area.'' This was associated with a normalization of the calculated resistances to flow and presure drop across the stenosis. To a minimal extent, recoil (0.1 ± 0.36 mm) was observed after stent implantation.