Stent underexpansion and residual reference segment stenosis are related to stent thrombosis after sirolimus-eluting stent implantation: an intravascular ultrasound study.
Fujii, Kenichi; Carlier, Stéphane; Mintz, Gary Set al.
2005 • In Journal of the American College of Cardiology, 45 (7), p. 995 - 998
[en] OBJECTIVES: We sought to determine the predictors of stent thrombosis after sirolimus-eluting stent (SES) implantation.
BACKGROUND: A number of cases of stent thrombosis have been reported after commercial release of the SES in the "real world," such that the U.S. Food and Drug Administration issued a warning.
METHODS: Fifteen patients who developed stent thrombosis after successful SES implantation were analyzed and compared with 45 matched control patients who had no evidence of stent thrombosis.
RESULTS: Minimum stent cross-sectional area (MSA) (4.3 +/- 1.6 mm(2) vs. 6.2 +/- 1.9 mm(2), p < 0.001) and stent expansion (0.65 +/- 0.18 vs. 0.85 +/- 0.14, p < 0.001) were significantly smaller in the stent thrombosis group than in the matched control patients. There was no significant difference in the rate of SES malapposition between the groups. However, the presence of a significant residual reference segment stenosis was more common in the stent thrombosis group compared with the matched control group (67% vs. 9%, p < 0.001). Independent predictors of stent thrombosis were stent underexpansion (p = 0.03) and a significant residual reference segment stenosis (p = 0.02).
CONCLUSIONS: Stent underexpansion and residual reference segment stenosis are associated with stent thrombosis after successful SES implantation.
Disciplines :
Cardiovascular & respiratory systems
Author, co-author :
Fujii, Kenichi; Cardiovascular Research Foundation, Columbia University Medical Center, 55 East 59th Street, New York, NY 10022, USA
Carlier, Stéphane ; Columbia University Medical Center > Cardiovascular Research Foundation
Mintz, Gary S; Columbia University Medical Center, Cardiovascular Research Foundation, New York, NY, United States
Yang, Yi-ming; Columbia University Medical Center, Cardiovascular Research Foundation, New York, NY, United States
Moussa, Issam; Columbia University Medical Center, Cardiovascular Research Foundation, New York, NY, United States
Weisz, Giora; Columbia University Medical Center, Cardiovascular Research Foundation, New York, NY, United States
Dangas, George; Columbia University Medical Center, Cardiovascular Research Foundation, New York, NY, United States
Mehran, Roxana; Columbia University Medical Center, Cardiovascular Research Foundation, New York, NY, United States
Lansky, Alexandra J; Columbia University Medical Center, Cardiovascular Research Foundation, New York, NY, United States
Kreps, Edward M; Columbia University Medical Center, Cardiovascular Research Foundation, New York, NY, United States
Collins, Michael; Columbia University Medical Center, Cardiovascular Research Foundation, New York, NY, United States
Stone, Gregg W; Columbia University Medical Center, Cardiovascular Research Foundation, New York, NY, United States
Moses, Jeffrey W; Columbia University Medical Center, Cardiovascular Research Foundation, New York, NY, United States
Leon, Martin B; Columbia University Medical Center, Cardiovascular Research Foundation, New York, NY, United States
Stent underexpansion and residual reference segment stenosis are related to stent thrombosis after sirolimus-eluting stent implantation: an intravascular ultrasound study.
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