Efficacy of Endeavor zotarolimus-eluting stent implantation for the treatment of very late stent thrombosis with late-acquired incomplete stent apposition after sirolimus-eluting stent implantation

Kakefuda, Yuki; Sato, Akira; Watabe, Hiroaki; Aihara, H.; Nishina, Hidetaka; Noguchi, Yuichi; Hoshi, Tomoya; Aonuma, Kazutaka

doi:10.1007/s00380-015-0720-y

Cited by 1 publication

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“…The continuous administration of DAPT decreases the risk of ST; however, this cannot be generalized to the decrease of ST for lesions with PSS because there was not a significant difference in the duration of DAPT between the 2 groups. The implantation Endeavor ZES to treat VLST associated with ISA is useful and may provide effective treatment for lesions with segmental PSS because of full neointimal proliferation after Endeavor ZES implantation at the ISA site. However, we focused here on identifying the type of PSS that confers high risk for developing VLST.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Long‐Term Clinical Outcomes of Lesions Exhibiting Focal and Segmental Peri‐Stent Contrast Staining

Tokuda

Yamawaki

Takahara

et al. 2016

JAHA

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BackgroundPeri‐stent contrast staining (PSS) after metallic drug‐eluting stent deployment is associated with target lesion revascularization and very late stent thrombosis. However, the type of PSS that influences the clinical outcomes is unknown. Therefore, we aimed to reveal which PSS type was influencing clinical outcomes.Methods and ResultsThis study included 5580 de novo lesions of 4405 patients who were implanted with a first‐ or second‐generation drug‐eluting stent and who were evaluated using follow‐up angiography within 12 months after stent implantation. We compared the clinical outcomes of patients divided into focal PSS and segmental PSS groups for 6 years after stent implantation. Total PSS was observed in 97 lesions (2.2%), of which 42 and 55 lesions were focal and segmental PSS, respectively. Baseline characteristics were similar between groups, except for intraoperative chronic total occlusion (segmental PSS=47.3% versus focal PSS=11.9%, P=0.0001). The incidence of segmental PSS tended to be higher in patients with a first‐generation drug‐eluting stent (83.6% versus 16.4%, P=0.05). The cumulative incidence of stent thrombosis in the 6 years of segmental PSS group was significantly higher than that of the focal PSS group (13.9% versus 0%, P=0.04). The cumulative incidence of overall target lesion revascularization for restenosis, excluding target lesion revascularization procedures for stent thrombosis, was significantly higher in the segmental PSS group (38.0% versus 0%, P=0.01).ConclusionsThe incidence of segmental PSS tended to be higher in patients with a first‐generation drug‐eluting stent and appeared to be significantly associated with target lesion revascularization and stent thrombosis.

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Section: Discussionmentioning

confidence: 99%