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Abstract Coronary artery disease (CAD), is the most common of the cardiovascular diseases. Types include stable angina, unstable angina, myocardial infarction, and sudden cardiac death. Coronary angiography facilitates clarification as to whether presumed anginal chest pain originates from myocardial ischemia, as a consequence of a culprit lesion, or not. In the former case, the culprit lesion can subsequently be treated by means of PCI within the same procedure or by CABG, depending on lesion morphology and the patient’s risk profile. In the latter case, exclusion of a culprit lesion paves the way to subsequent diagnostic investigations ultimately revealing the cause of chest pain and/or myocardial injury Successful percutaneous coronary intervention (PCI) requires adequate lesion preparation, accurate stent sizing, and complete stent expansion. Stent underexpansion has been associated with increased risk of instent restenosis, target vessel revascularization, and may predispose to both early and late stent thrombosis. Sub-optimal stent expansion affects as many as 25–40% of all PCIs. This unacceptably high frequency of stent underexpansion suggests that current stent deployment techniques require refinement In the present study we studied 60 patients indicated for elective PCI ,30 patients randomized to high inflation pressure stent deployment at pressure (16-20 atm) and within limitations of manufacturer instructions and 30 patients were randomized to stent deployment at high pressure followed by routine post stenting NC balloon dilatation at high pressure All used stents were 2nd generation drug eluting stents (DES) with FDA or CE mark approval Both groups are examined by IVUS & SBS to assess optimal stent deployment and in group A, if stent was sub-optimally deployed in stent boost subtract imaging, additional non-compliant balloon dilatation was done then assessed by IVUS . All the studied population underwent history taking, clinical examination and ECG Coronary angiography, IVUS analysis & stent boost subtract imaging were done in all patient There were no significant differences between both groups regarding optimal stent deployment (expansion, opposition to vessel wall, symmetry index) There were no significant differences between both groups regarding complications (spasm, dissection, no reflow) between both groups Also, we found that heavy calcifications were associated by more inflation pressure, complication, less stent expansion and more asymmetrical deployment of stent We found also that increased stent length is associated with long inflation time for better stent deployment There significant positive linear correlation between MSD measure by SBS & that measured by IVUS. |