Xu et al developed a simple score based on findings seen during an intravascular ultrasound (IVUS) study performed after placement of a drug-eluting stent (DES). This can help to identify a patient who may benefit from more aggressive management. The authors are from Shenyang Northern Hospital in Shenyang, China.
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).
Specialty: Cardiology
ICD-10: ,