Angioscopic findings before and after thrombus-related drug-eluting stent failure

Kotani, Jun Ichi; Nanto, Shinsuke; Ueda, Yasunori; Uematsu, Masaaki; Nishino, Masami; Miyazaki, Shunichi; Yasaka, Yoshinori; Yasuda, Satoshi; Mizuno, Kyoichi

doi:10.1007/s12928-014-0301-5

Cited by 3 publications

(2 citation statements)

References 29 publications

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“…Although the drug eluting stent can reduce the risk of early stent thrombosis, it can increase the risk of delayed stent thrombosis. [10][11][12][13] The more stents, the higher the risk of stent thrombosis, [13,14] and the thrombus organization would lead to stent restenosis. [15][16][17] At the same time, the more stents, the greater the damage to blood vessels caused by the stent itself.…”

Section: Discussionmentioning

confidence: 99%

The number of stents was an independent risk of stent restenosis in patients undergoing percutaneous coronary intervention

Tang¹,

Cui

Liu³

et al. 2019

Medicine

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Percutaneous coronary intervention (PCI) is one of the most effective therapies for coronary artery disease, but stent restenosis remains an important clinical challenge. The studies about the independent effect of the number of stents on stent restenosis were limited.The purpose was to identify the independent effect of the number of stents on stent restenosis.A retrospective cohort study of data reuse.From July 2009 to August 2011, a total of 2338 cases met the inclusion and exclusion criteria.The univariate analysis showed that the number of stents was a risk of stent restenosis, the OR value was 1.30 (95% CI:1.15 to 1.47, P < .001). The multi-factor regression analysis also showed that the number of stents was an independent risk of stent restenosis, the adjusted OR value was 1.38 (95% CI: 1.15 to 1.66, P < .001).Compared with 1-2 stents, the adjusted OR values of 3-5 stents and more than 6 stents were respectively 2.20 (95% CI: 1.24 to 3.90, P = .007) and 5.33 (95% CI: 1.89 to 15.08, P = .002), and the trend adjusted OR values was 2.26 (95% CI: 1.43 to 3.59, P < .001).The subgroup analysis of multi-factor regression analysis showed that when patients with the following conditions: 50 < Age, female, non-DES or SES, the risk of stent restenosis increased obviously.The number of stents was an independent risk of stent restenosis in patients undergoing PCI, especially for patients with the following conditions: 2

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Section: Discussionmentioning

confidence: 99%

The number of stents was an independent risk of stent restenosis in patients undergoing percutaneous coronary intervention

Tang¹,

Cui

Liu³

et al. 2019

Medicine

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“…СЛК имеет значительно ниже уровни рестеноза стента по сравнению с голометаллическими стентами [5,6]. Однако существуют мнения о более высоком риске тромбоза стента после установки СЛК, так как малаппозиция и недостаточная эндотелизация стента были признаны факторами риска для тромбоза стента [7,8]. Показано, что ОКТ способна детально визуализировать положение и покрытие стента после установки в сосуд, и ОКТ снимки сопоставимы с данными гистологии соответствующей ткани [9][10][11].…”

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Role of Lipid-Rich Plaques in Outcomes of Drug-Eluting Stent Implantation in Patients with Coronary Artery Disease

Mustafina

Ишметов

Павлов

et al. 2019

Kreativnaâ hirurgiâ i onkologiâ

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Введение. Влияние липидного содержания атеросклеротической бляшки на результаты стентирования пораженной артерии требует уточнения. Целью данного исследования явилось изучение результатов стентирования у пациентов с бляшками, богатыми липидами, и нелипидными бляшками после имплантации стентов с лекарственным покрытием методом оптической когерентной томографии (ОКТ). Материалы и методы. В исследование были включены 43 пациента, из которых 26 пациентов были в группе с бляшками, богатыми липидами, и 17-в группе с нелипидными бляшками. Степень содержания липидов в бляшке была оценена с помощью ОКТ. Была рассчитана доля снимков, содержащих малаппозицию, протрузию ткани, диссекцию и тромб в соответствии с установленными критериями. Результаты и обсуждение. В группе бляшек, богатых липидами, была выше частота сахарного диабета 2-го типа. Данные ОКТ, проведенного после ЧКВ, показали, что в группе бляшек, богатых липидами, была выше доля малаппозиции стратов и протрузий ткани. В группе бляшек, богатых липидами, по сравнению с нелипидными бляшками чаще встречался остаточный тромб. Заключение. Бляшки, богатые липидами, ассоциированы с более частой малаппозицией, протрузией ткани и тромбом после стентирования, что свидетельствует о связи типа атеросклеротического поражения артерии и неоптимальных результатов установки стентов. Ключевые слова: ишемическая болезнь сердца, атеросклеротическая бляшка, визуализация, оптическая когерентная томография, стенты с лекарственным покрытием, сиролимус, чрескожное коронарное вмешательство

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Stent Thrombosis and Intrastent Thrombus Formation in Patients Undergoing Elective PCI: Results of an Angioscopic Substudy of the Randomized Trial PRASFIT-Elective (PRASugrel for Japanese PatIenTs with Coronary Artery Disease Undergoing Elective PCI)

et al. 2018

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Background: Angioscopy was performed in a group of patients in the PRASugrel For Japanese PatIenTs with Coronary Artery Disease Undergoing Elective PCI (PRASFIT-Elective) study to determine the incidence and clinical features of stent thrombosis. Stent thrombosis is an infrequent, but potentially severe event that may require revascularization or lead to other clinically significant events. Its incidence and clinical features in Japanese patients undergoing elective percutaneous coronary intervention (PCI) are poorly understood, especially in those receiving dual antiplatelet therapy with prasugrel or clopidogrel in combination with aspirin. Methods: Coronary angioscopy was performed before and at 36 weeks after elective PCI in 19 and 14 patients treated with prasugrel and clopidogrel, respectively, across eight participating institutions. Coronary angioscopic images were adjudicated by independent staff at a central laboratory to assess intrastent thrombus, neointimal coverage, and plaque color. Results: The proportion of stents with a red thrombus decreased from 57.9% (11/19) to 21.1% (4/19) in the prasugrel group (P = 0.0082) and from 50.0% (7/14) to 35.7% (5/14) in the clopidogrel group (P = 0.3173) at stenting to the follow-up visit. Platelet reactivity at 4 weeks was similar between patients with or without a red intrastent thrombus. Stent coverage was classified as Grade 1 in most of the patients, and the yellow plaque classification was Grade 0-2 in most of the patients. Conclusions: Prasugrel and clopidogrel were associated with low rates of red thrombus after 36 weeks of dualantiplatelet therapy after PCI. Stent coverage and yellow plaque classification were similar in prasugrel-and clopidogrel-treated patients.

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Angioscopic findings before and after thrombus-related drug-eluting stent failure

Cited by 3 publications

References 29 publications

The number of stents was an independent risk of stent restenosis in patients undergoing percutaneous coronary intervention

The number of stents was an independent risk of stent restenosis in patients undergoing percutaneous coronary intervention

Role of Lipid-Rich Plaques in Outcomes of Drug-Eluting Stent Implantation in Patients with Coronary Artery Disease

Stent Thrombosis and Intrastent Thrombus Formation in Patients Undergoing Elective PCI: Results of an Angioscopic Substudy of the Randomized Trial PRASFIT-Elective (PRASugrel for Japanese PatIenTs with Coronary Artery Disease Undergoing Elective PCI)

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