Mechanical complications of everolimus-eluting stents associated with adverse events: an intravascular ultrasound study

Inaba, Shinji; Mintz, Gary S.; Yun, Kyeong Ho; Yakushiji, Tadayuki; Shimizu, Tomohiro; Kang, Soo Jin; Généreux, Philippe; Weisz, Giora; Rabbani, Le Roy E.; Moses, Jeffrey W.; Stone, Gregg W.; Maehara, Akiko

doi:10.4244/eijv9i11a220

Cited by 24 publications

(20 citation statements)

References 25 publications

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“…5 In addition, aggressive guide catheter manipulation, use of imaging devices including IVUS or optical coherence tomography, and multiple ballooning have been suggested as factors associated with LSD occurrence. 2,3,9,19,20 Our subgroup analysis also showed that any use of secondary devices was the single most important independent factor predicting QCA-based LSD, regardless of the lesion or stent factors. If the proximal portion of the stent is not completely apposed to the vessel wall, frequent use of secondary devices may increase the chance of contact with unopposed struts especially when wire bias exists resulting in the occurrence of LSD.…”

Section: Procedural Insights On the Mechanism Of Lsdmentioning

confidence: 76%

“…18 In line with these results, an IVUS analysis also reported that the incidence of LSD was similar among various types of second-generation DES. 19 These findings suggest that factors other than the stent platform itself, such as lesion or procedural factors, may have had a greater impact on the occurrence of QCA-based LSD.…”

Section: Rhee Et Al Risk Factors Of Longitudinal Stent Deformationmentioning

confidence: 79%

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Predictors and Long-Term Clinical Outcome of Longitudinal Stent Deformation

Rhee

Park²,

Lee

et al. 2017

Circ: Cardiovascular Interventions

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Background-There are limited data on the frequency of and factors associated with quantitative coronary angiography (QCA)-defined longitudinal stent deformation (LSD) in various contemporary drug-eluting stents platforms. This study sought to evaluate the predictors of LSD and its long-term clinical implication. Methods and Results-A patient-level pooled analysis was performed with 7350 lesions in 5871 patients treated with platinum-chromium-based everolimus-eluting stent (Promus Element), cobalt-chromium-based everolimus-eluting stent (Promus/Xience V), or cobalt-chromium-based zotarolimus-eluting stent (Endeavor Resolute). QCA was performed to analyze differences of stent length between immediate post-deployment and final post-procedure. Independent factors associated with LSD were identified. Clinical outcomes at 3 years were compared between those with and without QCAbased LSD. The frequency of QCA-based LSD was 1.12% (82 cases). Nine of these cases were angiographically overt. Left main or ostial lesion, bifurcation treatment with provisional side branch stenting or ballooning, additional downstream intervention of a distal lesion, intravascular ultrasound use, and adjunctive post-dilatation were independently associated with QCA-based LSD. The type of stent was not associated with QCA-based LSD. Rates of target lesion failure were nominally higher in lesions with QCA-based LSD than in those without (8.97% versus 5.88%; hazard ratio, 1.415; 95% confidence interval, 0.631-3.175; P=0.399). Conclusions-LSD is uncommon with contemporary drug-eluting stents, regardless of the type of stent platform. LSD is mainly associated with procedural factors, especially with additional downstream procedures which require the passage of devices through the stent. Careful manipulation of poststent imaging or procedural devices is required to prevent LSD. More data are needed to clarify the impact of LSD on clinical events. (Circ Cardiovasc Interv. 2017;10:e005518.

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Section: Procedural Insights On the Mechanism Of Lsdmentioning

confidence: 76%

Section: Rhee Et Al Risk Factors Of Longitudinal Stent Deformationmentioning

confidence: 79%

Predictors and Long-Term Clinical Outcome of Longitudinal Stent Deformation

Rhee

Park²,

Lee

et al. 2017

Circ: Cardiovascular Interventions

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“…partial or complete stent fracture, strut fracture with overlapping stent fragments, and longitudinal deformation) have been associated with excessive neo-intimal hyperplasia, ISR and repeat revascularisation. 30 Sonoda et al 31 observed a correlation between BMS and SES MSA and long term development of ISR. Fujii et al 32 found stent under expansion (MSA < 5.0 mm 2 ) to be associated with ISR after SES implantation.…”

Section: Ivus For Bms and Des Implantationmentioning

confidence: 98%

Impact of Intravascular Ultrasound in Clinical Practice

Vásquez

Mistry

Singh

2014

Interventional Cardiology Review

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Intravascular ultrasound (IVUS) has expanded our understanding of atherosclerotic plaque morphology, and provides an opportunity to guide cardiovascular interventions and evaluate results. Use of this technique requires understanding of ultrasound physics, catheter differences, skills in vessel, plaque and stent quantification and knowledge of artifacts and various physiologic and pathologic findings. Optimal cardiovascular interventions should result in absence of inflow or outflow obstruction, precise geographic landing, while attaining the largest feasible luminal gain without plaque protrusion, vessel dissection or perforation and, if deployed, with complete stent expansion and apposition to the vessel wall. IVUS is safe, cost efficient and effectively optimises cardiovascular interventions. In addition, IVUS improves outcomes when used to guide coronary interventions using bare metal stents (BMS) and drug eluting stents (DES). The role of IVUS in endovascular therapy is rapidly expanding. This review will focus on the impact of IVUS in clinical practice.

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“…The most common categories are longitudinal stent deformation, stent fracture, stent under expansion and stent recoil [18]. The MSF rate reported that from 136 patients undergoing stent implantation, 17 patients (12.5%) endure mechanical stent failure [19]. From 17 patients, 16 having focal and 1 having in stent restenosis (ISR) [19].…”

Section: Failure Of Stentmentioning

confidence: 99%

“…There are three types of diffuse ISR, which are confined to stent margin, beyond stent margin, and total occlusion or have a flow rate 0 [21]. Complete stent fracture occur in one patient (5.9%), partial stent fracture endure by 3 patients (17.6%) while 13 (76.5%) more experienced longitudinal deformation and stent's strut fracture [19].…”

Section: Failure Of Stentmentioning

confidence: 99%

A review of stent’s failure on patent ductus arteriosus

Lazim

Ismail

Taib

et al. 2017

IOP Conf. Ser.: Mater. Sci. Eng.

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Abstract. This paper presents a review of stent's failure on patent ductus arteriosus (PDA). Ductus arteriosus (DA) is an opening for newborn babies and some patient that experienced cynotic congenital heart disease (CCHD) should maintain the duct opening for survival. To date, there are no specific research on mechanical stent failure study at DA. The challenging of the stent implantation on PDA is the PDA morphology. The failure of stent in term of stent fracture have been reported and reviewed in this paper. Furthermore, the failure prediction of stent is important for further stent design development. The morphology of PDA, stent type and material used in PDA and method for accessing the failure of stent is reviewed.

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Mechanical complications of everolimus-eluting stents associated with adverse events: an intravascular ultrasound study

Abstract: We found EES mechanical complications, often followed by longitudinal deformation or fracture leading to excessive neointimal hyperplasia, in-stent restenosis, and repeat revascularisation.

Cited by 24 publications

References 25 publications

Predictors and Long-Term Clinical Outcome of Longitudinal Stent Deformation

Predictors and Long-Term Clinical Outcome of Longitudinal Stent Deformation

Impact of Intravascular Ultrasound in Clinical Practice

A review of stent’s failure on patent ductus arteriosus

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