Comparison of intravascular ultrasonic imaging with versus without incomplete stent apposition at follow-up after drug-eluting stent implantation

Purpose Coronary bioresorbable stents (BRS) do not produce blooming artifacts on computed tomography (CT), in contrast to metallic stents, as they are made of a bioresorbable polymer and are radiolucent. They allow to evaluate the coronary plaque beneath. The low-attenuation plaque (LAP) suggests plaque vulnerability and is CT assessable. The aim of our study was to show the possibility of a non-invasive CT evaluation of the volume and the LAP composition of the intra- and juxta-stent plaque. Methodology In our prospective longitudinal study, we recruited 27 consecutive patients (35 BRS stents total; mean age 60 +/- 9 years) with bioresorbable stents for a 256-slice ECG-synchronized CT evaluation at 1- and 12-months post stent implantation. Total plaque volume (mm3), absolute and relative (%) LAP volume per block in the pre- intra- and post-stent zones were analyzed; comparison 1- and 12-months post-implantation of BRS. Changes in the previously mentioned variables were assessed by the mixed effects models with and without spline, which also accounted for the correlation between repeated measurements. Results Our block or spline model analysis has shown no significant difference in plaque or absolute LAP volumes in pre- intra- and post-stent zones between 1 and 12 months. Interestingly, % LAP volume increases near-significantly in the distal block of the intrastent at 12-mo follow-up (from 23.38 ± 1.80% to 26.90 ± 2.22% (increase of 15%), p = 0.052). Conclusion Our study demonstrates the feasibility of the repeated non-invasive quantitative analysis of the intrastent coronary plaque and of the in-stent lumen by CT scan.

show abstract

Very Late Stent Thrombosis in Late Stent Malapposition After Sirolimus-Eluting Stent Implantation

zhang

Qian

2007

Int. Heart J.

Self Cite

View full text Add to dashboard Cite

SUMMARYLate stent malapposition (LSM) has been demonstrated to be more common after drug-eluting stent (DES) implantation than after bare-metal stent (BMS) implantation. To date, this unusual intravascular ultrasonic finding after DES implantation, however, has not received enough attention, because previous studies suggested few adverse clinical sequelae from LSM. We present a case of angiographically-confirmed very late stent thrombosis (ST) in LSM after elective implantation of sirolimus-eluting stents. In this 32-year-old male patient, very late ST occurred at 29 months after DES implantation and at 20 months after the identification of LSM. Although this patient had received sufficient dual antiplatelet therapy with aspirin and clopidogrel for more than 1 year, he suffered from ST shortly after the discontinuation of clopidogrel. Thus, patients with LSM may pose a significant risk for very late ST after discontinuation of dual antiplatelet therapy. The findings suggest that dual antiplatelet therapy should be further prolonged in patients with LSM. ( Despite these promising results, some studies found an increased rate of late stent malapposition (LSM) in DESs compared to traditional bare-metal stents (BMSs). [4][5][6][7] To date, this unusual intravascular ultrasound (IVUS) finding after DES implantation, however, has not received enough attention, because almost all of the previous studies suggested few adverse clinical sequelae from LSM. [4][5][6][7][8] We present here a case of angiographically-confirmed very late stent thrombosis (ST) in LSM after elective implantation of sirolimus-eluting stents (SESs) to draw more attention to the significance of LSM in DESs.From the

show abstract

scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.

Contact Info

customersupport@researchsolutions.com

10624 S. Eastern Ave., Ste. A-614

Henderson, NV 89052, USA

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

Blog Terms and Conditions API Terms Privacy Policy Contact Cookie Preferences Do Not Sell or Share My Personal Information

Made with 💙 for researchers

Part of the Research Solutions Family.

Comparison of intravascular ultrasonic imaging with versus without incomplete stent apposition at follow-up after drug-eluting stent implantation

Abstract: ISA at follow-up after DES implantation for de novo coronary lesions was associated with a larger EEM area.

Cited by 3 publications

References 36 publications

A more than 2-year follow-up of incomplete apposition after drug-eluting stent implantation

A more than 2-year follow-up of incomplete apposition after drug-eluting stent implantation

Coronary bioresorbable stents: Non-invasive quantitative evaluation of intra- and juxta-stent plaque composition—A computed tomography longitudinal study

Very Late Stent Thrombosis in Late Stent Malapposition After Sirolimus-Eluting Stent Implantation

Contact Info

Product

Resources

About