Drug-eluting stents in the real world: how intravascular ultrasound can improve clinical outcome.

Although the benefits of drug-eluting stents for the treatment of native coronary lesions in patients undergoing percutaneous coronary interventions have been demonstrated in multiple clinical trials, there remains concern about the risk of late stent thrombosis. The MATRIX registry, a prospective study designed to reflect clinical conditions, has enrolled a varied population of complex patients who have received the sirolimus-eluting stent (SES) and long-term dual antiplatelet therapy. Contributing to the low rate of stent thrombosis and other complications after SES deployment in this study is the routine use of intravascular ultrasound (IVUS) imaging before and after implantation at a high rate (38%). Important technical considerations for the IVUS operator include stent expansion, residual edge stenosis, and malapposition. Ensuring adequate stent dimensions and wall contact can contribute to successful outcomes in patients receiving SES.