James C. Spratt1, MD, MBChB, BSc, FRCP; John D. Hung2, MBChB, PhD, MRCP
1. St George's, University of London, London, United Kingdom; 2. St George's University Hospitals NHS Foundation Trust, London, United Kingdom
Stent failure represents an unwanted, yet common1 cause of repeat coronary revascularisation of which underexpansion remains the leading cause. As might be expected, this unscheduled stop on the “revascularisation journey” predicts adverse clinical outcomes and is challenging to treat.
Stent underexpansion frequently relates to failure to modify the lesion sufficiently prior to stent deployment but may also be due to stent undersizing. Whilst coronary arterial calcium represents the plaque subtype with the lowest compliance and thus the most resistance to expansion, incomplete preparation of fibrous plaque may also lead to underexpansion, either through “primary” underexpansion ...