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Outcome After Acute Incomplete Sirolimus-Eluting Stent Apposition as Assessed by Serial Intravascular Ultrasound

2006; Elsevier BV; Volume: 98; Issue: 4 Linguagem: Inglês

10.1016/j.amjcard.2006.02.050

1879-1913

Masashi Kimura, Gary S. Mintz, Stéphane Carlier, Hideo Takebayashi, Kenichi Fujii, Koichi Sano, Takenori Yasuda, Ricardo A. Costa, J. Ribamar Costa, Jie Quen, Kaoru Tanaka, Joanna Lui, Giora Weisz, Issam Moussa, George Dangas, Roxana Mehran, Alexandra J. Lansky, Edward M. Kreps, Michael Collins, Gregg W. Stone, Jeffrey W. Moses, Martin B. Leon,

Aortic aneurysm repair treatments

We investigated the fate of postprocedural incomplete stent apposition (ISA) after sirolimus-eluting stent (SES) implantation by evaluating long-term intravascular ultrasound findings in 168 consecutive patients (182 de novo lesions). Postprocedural ISA was defined as > or = 1 stent strut that was clearly separated from the vessel wall with evidence of blood speckle behind the strut without overlapping a side branch. After SES implantation, there were 61 ISA sites in 46 stents in 31 patients (23 at the proximal edge, 7 at the distal edge, and 31 within the stent body). There were no clinical, procedural, or intravascular ultrasound measurement differences between patients and lesions with versus without ISA. At follow-up, 15 acute ISA sites (25%) in 11 patients completely resolved and 40 sites (75%) in 20 patients persisted, although 32 of 46 persisting ISA sites (70%) decreased. There was a greater decrease in effective lumen area and a greater increase in peristent plaque area in the complete-resolution group than in the persistent-ISA group. No lesion developed stent thrombosis or in-stent restenosis (angiographic diameter stenosis > 50%). Six acute ISA sites were also associated with new, late acquired ISA, only 1 of which resulted in aneurysm formation. Although most ISAs after SES implantation do not resolve completely, the incidence of restenosis or thrombosis is not affected.