Late stent malapposition after drug-eluting stent implantation : An intravascular ultrasound analysis with long-term follow-up

• Published in: Circulation (New York, N.Y.) N.Y.), 2006-01, Vol.113 (3), p.414-419
• Main Authors: HONG, Myeong-Ki, MINTZ, Gary S, CHEONG, Sang-Sig, SONG, Jae-Kwan, KIM, Jae-Joong, PARK, Seong-Wook, PARK, Seung-Jung, CHEOL WHAN LEE, PARK, Duk-Woo, PARK, Kyoung-Min, LEE, Bong-Ki, KIM, Young-Hak, SONG, Jong-Min, HAN, Ki-Hoon, KANG, Duk-Hyun
• Format: Article
• Language: English
• Subjects: Adult; Aged; Angioplasty, Balloon, Coronary; Antineoplastic Agents, Phytogenic - administration & dosage; Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; Cardiovascular system; Coronary Angiography; Coronary Artery Disease - diagnostic imaging; Coronary Artery Disease - epidemiology; Coronary Artery Disease - therapy; Diseases of the cardiovascular system; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous; Echocardiography; Female; Follow-Up Studies; Humans; Immunosuppressive Agents - administration & dosage; Investigative techniques, diagnostic techniques (general aspects); Logistic Models; Male; Medical sciences; Middle Aged; Paclitaxel - administration & dosage; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Retrospective Studies; Sirolimus - administration & dosage; Stents - adverse effects; Stents - statistics & numerical data; Ultrasonic investigative techniques
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/CIRCULATIONAHA.105.563403

Late stent malapposition (LSM) after drug-eluting stent (DES) implantation has not been evaluated sufficiently in real-world practice. We evaluated the incidence, mechanisms, predictors, and long-term prognosis of LSM after DES implantation in 557 patients (705 native lesions; sirolimus-eluting stent in 538 lesions and paclitaxel-eluting stent in 167 lesions) in whom intravascular ultrasound was performed at index and 6-month follow-up. LSM occurred in 82 patients with 85 lesions (12.1% overall, 95% CI 9.7% to 14.5%, 71 lesions (13.2%) in sirolimus-eluting stents and 14 lesions [8.4%] in paclitaxel-eluting stents, P=0.12]; the incidence was 25.0% (4/16) after directional coronary atherectomy before stenting, 27.5% (14/51) in chronic total occlusion lesions, and 31.8% (7/22) after primary stenting in acute myocardial infarction (P=0.13, P