Patient selection: following placement of a drug-eluting stent
Study: intravascular ultrasound (IVUS)
Parameters:
(1) i = inflow/outflow disease (significant residual disease in coronary segments outside of the treated segment, defined as > 70% plaque burden and a cross-sectional area < 4 square mm)
(2) M = malapposition (separation of at least one stent strut from the luminal border)
(3) U = underexpansion (inadequate stent expansion)
(4) T = tissure protrusion (visible tissue on the luminal side of stent struts)
(5) E = edge dissection (with 3 categories – intimal, medial and adventitial)
|
Parameter
|
Finding
|
Points
|
|
inflow/outflow disease
|
absent
|
0
|
|
|
present
|
1
|
|
malapposition
|
absent
|
0
|
|
|
present
|
1
|
|
underexpansion
|
absent
|
0
|
|
|
present
|
2
|
|
tissue protrusion
|
absent
|
0
|
|
|
present
|
1
|
|
edge dissection
|
absent
|
0
|
|
|
present
|
1
|
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 6
• The higher the score the greater the risk of a major adverse cardiac event (MACE).
• A patient with an iMUTE score < 2 had a good chance of being free of a target vessel revascularization at 1 year (1.5% vs 7% if iMUTE >=2).
