Intraprocedural stent thrombosis during implantation of sirolimus-eluting stents.
BACKGROUND
Intraprocedural stent thrombosis (IPST) is a rare event (<0.01% in our experience with bare metal stents), with the exception of specific settings such as acute myocardial infarction, thrombus-containing lesions, and dissections. We report the occurrence of this event during elective implantation of sirolimus-eluting stents.


RESULTS
Between April 2002 and August 2003, 670 patients with 1362 lesions were treated with Cypher (Cordis, Johnson and Johnson Co) sirolimus-eluting stent implantation in San Raffaele Hospital and EMO Centro Cuore Columbus. Diabetes mellitus was present in 142 patients (21%), and 164 (24.5%) had unstable angina. Pretreatment with glycoprotein IIb/IIIa (GP IIb/IIIa) inhibitors was carried out in 235 patients (35%). Total stent length per vessel was 42.9+/-28.3 mm. IPST occurred in 5 patients (0.7%). None of the patients with IPST were pretreated with GP IIb/IIIa inhibitors. Using univariate exact logistic regression, only total stent length per vessel, in millimeters (exact OR, 1.03; 95% CI, 1.011 to 1.046; P=0.0028), was associated with the occurrence of IPST.


CONCLUSIONS
Stent length was associated with the occurrence of IPST. Particular attention will need to be directed to this potential complication when long sirolimus-eluting stents are being used.
Chieffo
Alaide
A
San Raffaele Hospital, Milan, Italy.
Bonizzoni
Erminio
E
Orlic
Dejan
D
Stankovic
Goran
G
Rogacka
Renata
R
Airoldi
Flavio
F
Mikhail
Ghada W
GW
Montorfano
Matteo
M
Michev
Iassen
I
Carlino
Mauro
M
Colombo
Antonio
A
D000328:Adult; D000368:Aged; D003328:Coronary Thrombosis / Q000453:epidemiology / Q000209:etiology*; D004867:Equipment Design; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization / Q000009:adverse effects* / Q000295:instrumentation; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000037:antagonists & inhibitors; D020123:Sirolimus / Q000008:administration & dosage*; D015607:Stents / Q000009:adverse effects*
D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D020123:Sirolimus