Long-term follow-up of incomplete stent apposition in patients who received sirolimus-eluting stent for de novo coronary lesions: an intravascular ultrasound analysis.

Abstract

BACKGROUND:

Incomplete stent apposition (ISA) has been previously documented after sirolimus-eluting stent (SES) implantation. The aim of this study was to investigate the long-term intravascular ultrasound (IVUS) findings of ISA in patients who received SES.

METHODS AND RESULTS:

A total of 13 patients who received SES and showed ISA at follow-up IVUS (follow-up I) were investigated. IVUS was performed on all of these patients 12 months later (follow-up II). Quantitative ISA area measurement was also performed at follow-up I and II. No vascular remodeling was observed in the vessel segment with ISA; external elastic membrane area was 19.4+/-6.6 versus 19.5+/-6.4 mm2 at follow-up I and II, respectively. There was also no significant change in external elastic membrane area between vessel segment with ISA and without ISA (+1.5% versus -3.0%, respectively; P=0.27) at late follow-up. The ISA area, either including (2.5+/-1.7 versus 3.8+/-6.3 mm2; P=NS) or excluding (2.5+/-1.8 versus 2.4+/-1.7 mm2; P=NS) a single patient with aneurysm formation, was not significantly different between follow-up I and II. One patient manifested a coronary aneurysm in the stented segment at late follow-up that was probably present at the initial follow-up but masked by thrombus. It was successfully treated with a covered stent. All patients were asymptomatic, and no patient experienced late thrombotic occlusion.

CONCLUSIONS:

Vessel dimensions and area of ISA did not change over time, except for 1 coronary aneurysm that became apparent. ISA after implantation of a SES was not associated with adverse events at late follow-up.

• Authors: Muzaffer Degertekin, Patrick W Serruys, Kengo Tanabe, Chi Hang Lee, J Edouardo Sousa, Antonio Colombo, Marie-Claude Morice, Jurgen M R Ligthart, Pim J de Feyter
• Journal: Circulation (Circulation) Vol. 108 Issue 22 Pg. 2747-50 (Dec 02 2003) ISSN: 1524-4539 [Electronic] United States
• PMID: 14638542 (Publication Type: Journal Article)

Chemical References

• Drug Implants
• Sirolimus

Topics

• Blood Vessel Prosthesis Implantation (adverse effects)
• Coronary Angiography
• Coronary Artery Disease (diagnostic imaging, therapy)
• Coronary Vessels (diagnostic imaging, drug effects)
• Drug Implants (adverse effects)
• Female
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Randomized Controlled Trials as Topic (statistics & numerical data)
• Sirolimus (adverse effects, therapeutic use)
• Stents (adverse effects, statistics & numerical data)
• Time
• Treatment Outcome
• Ultrasonography, Interventional
• Vascular Patency (drug effects)