alexa Outcome after acute incomplete sirolimus-eluting stent apposition as assessed by serial intravascular ultrasound.


Journal of Cardiovascular Diseases & Diagnosis

Author(s): Kimura M, Mintz GS, Carlier S, Takebayashi H, Fujii K,

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Abstract 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. This article was published in Am J Cardiol and referenced in Journal of Cardiovascular Diseases & Diagnosis

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