Stent oversizing or not-oversizing? An unresolved dilemma

Primary PCI plus stent implantation is indicated for treatment of acute coronary syndrome. Technically, due to the difference in lumen diameter between vessel portions and stent size in some coronary arteries, post-expansion of the stent is usually necessary to match proximal reference diameter and optimize stent apposition. Incomplete stent apposition has been associated with increased risk of in stent restenosis (ISR) and stent thrombosis (1) despite new stent technologies have largely reduced this risk (2-3). Although new antiplatelet drugs showed a more rapid onset of action and a stronger effect (4-5), stent apposition remains an important risk factor for stent thrombosis. As stent pos…