Beyond Angiography: Comparing 3DStent and IVUS for Stent Optimization. Seeing is Believing: 3DStent Technology in the Cath Lab.
Beyond Angiography: Comparing 3DStent and IVUS for Stent Optimization. Seeing is Believing: 3DStent Technology in the Cath Lab.
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Presented at SCAI 2025 Scientific Sessions.
1. Background
• Traditional angiography has remained relatively unchanged for decades.
• A new tool, 3DStent (GE HealthCare for aaaplatform), uses cone beam CT + motion compensation to create interactive 3D reconstructions of stents during PCI.
2. Clinical Utility
• Enables real-time stent visualization without extra catheters.
• Helps assess stent expansion and detect underexpansion or malapposition before finishing PCI.
• Saves time compared with IVUS/OCT, which add procedural steps and cost.
3. Adoption & Experience
• Dr. Shailendra Singh (Pennsylvania): Early adopter, >1,500 PCIs annually.
• Reported added confidence and efficiency, no significant increase in procedure time.
4. Accuracy vs. IVUS
• Dr. Carey Kimmelstiel (Tufts Medical Center) compared 3DStent with IVUS in 30 patients.
• Focused on Minimal Stent Area (MSA)—a key predictor of long-term outcomes.
• Results: High correlation between 3DStent and IVUS; minimal interobserver variability.
5. Clinical Case Example
• 73-year-old woman with stent failure suspicion.
• 3DStent revealed severe calcification with stent underexpansion.
• Treatment shifted from new stent/atherectomy to intravascular lithotripsy + drug-coated balloon → MSA improved from 4.2 mm² → 8.4 mm².
• Patient improved significantly.
6. Advantages
• Comparable accuracy to IVUS.
• Faster workflow (3D spin <1 minute).
• Data can be stored in EHR and shown to patients.
• “No downside”—adds assurance at end of PCI, confirming success.
7. Future Outlook
• Potential beyond coronary interventions.
• Represents a meaningful leap forward in intraprocedural imaging, enhancing precision and outcomes in interventional cardiology.
