Relation of Drug-Eluting Stent Strut Distribution to Stent Thrombosis in Coronary Arteries

The distribution of stent struts is critical to drug deposition and, therefore, may affect the amount of neointima and the risk of thrombosis after drug-eluting stent (DES) implantation. The aim of our study was to evaluate stent strut distribution in the setting of a drug-eluting stent thrombosis (...

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Bibliographic Details
Published in:The American journal of cardiology Vol. 104; no. 3; pp. 343 - 348
Main Authors: Opolski, Maksymilian P., Pracon, Radoslaw, Mintz, Gary S., Okabe, Teruo, Pregowski, Jerzy, Lee, Sung Yun, van der Waal, Eva C., Kalinczuk, Lukasz, Roy, Probal, Smith, Kimberly A., Torguson, Rebecca, Xue, Zhenyi, Satler, Lowell F., Kent, Kenneth M., Pichard, Augusto D., Waksman, Ron, Weissman, Neil J.
Format: Journal Article
Language:English
Published: New York, NY Elsevier Inc 01.08.2009
Elsevier
Elsevier Limited
Subjects:
Aged
Biological and medical sciences
Cardiology
Cardiology. Vascular system
Cardiovascular
Cardiovascular disease
Case-Control Studies
Coronary Angiography
Coronary Thrombosis - diagnostic imaging
Coronary Thrombosis - etiology
Coronary vessels
Coronary Vessels - diagnostic imaging
Drug-Eluting Stents - adverse effects
Drugs
Female
Humans
Male
Medical sciences
Middle Aged
Retrospective Studies
Stents
Thrombosis
Treatment Outcome
Ultrasonography, Interventional
Vascular disease
Endoprosthesis
Coronary artery
Distribution
Cardiovascular disease
Circulatory system
Cardiology
Drug eluting stent
Thrombosis
ISSN:0002-9149, 1879-1913, 1879-1913
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Summary:The distribution of stent struts is critical to drug deposition and, therefore, may affect the amount of neointima and the risk of thrombosis after drug-eluting stent (DES) implantation. The aim of our study was to evaluate stent strut distribution in the setting of a drug-eluting stent thrombosis (ST). We retrospectively analyzed postprocedural intravascular ultrasound (IVUS) images of 13 patients who subsequently developed ST (14 DES thrombotic lesions) and a control group of 27 patients (30 DES lesions) matched for stent type and presence of chronic renal failure. In addition to standard IVUS measurements, visible struts were counted and maximum interstrut angle was measured at 1-mm intervals. Early ST was defined as ≤30 days after DES deployment and late ST as >30 days after DES deployment. Compared with DES controls, the ST group had a larger maximum interstrut angle (60.8 ± 8.3° vs 55.7 ± 4.8°, p = 0.014) and a similar number of stent struts (8.4 ± 0.6 vs 8.7 ± 0.6, p = NS). Maximum interstrut angle tended to be larger in late ST than in early ST (66.1 ± 10.8° vs 57.8 ± 5.0°, p = 0.071). The incidence of maximum interstrut angles ≥90° and ≥120° observed continuously for ≥2 mm of stent length was higher in the ST group (p = 0.009 and p = 0.096, respectively). In conclusion, DES-treated lesions leading to ST had larger maximum interstrut gaps distributed circumferentially and longitudinally, but a similar number of struts at the time of DES implantation compared with DES controls.
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ISSN:0002-9149
1879-1913
1879-1913
DOI:10.1016/j.amjcard.2009.03.047