title: Characterization of plaque prolapse after drug-eluting stent implantation in diabetic patients: a three-dimensional volumetric intravascular ultrasound outcome study.
abstract: OBJECTIVE
  The aim of this research was to evaluate the plaque prolapse (PP) phenomenon after bare-metal (BMS) and drug-eluting stent (DES) implantation in patients with diabetes mellitus using 3-dimensional volumetric intravascular ultrasound (IVUS).
  
  
  BACKGROUND
  Plaque prolapse has been observed in up to 22% of patients treated with BMS. Diabetic patients have a larger atherothrombotic burden and may be more prone to have PP. However, the incidence of PP and its clinical impact after DES implantation is unknown.
  
  
  METHODS
  Three-dimensional IVUS was performed after intervention and at 9-month follow-up in 168 patients with diabetes (205 lesions) treated with bare BX Velocity stents ((BX Velocity/Sonic, Cordis, Johnson & Johnson) (BMS, n = 65), sirolimus-eluting stents (Cypher, Cordis) (SES, n = 69), and paclitaxel-eluting stents (Taxus, Boston Scientific, Natick, Massachusetts) (PES, n = 71). Intravascular ultrasound data at the sites of PP were compared with stented segments without PP in each lesion. Outcomes were evaluated at 9- and 12-month follow-up.
  
  
  RESULTS
  There were 42 sites of PP (BMS = 11, SES = 11, PES = 20, p = NS) in 34 stented segments of 205 (16.6%) lesions. Plaque prolapse was more frequent in the right coronary artery and in chronic total occlusion lesions. Post-procedure PP volume was 1.95 mm3 in BMS, 2.96 mm3 in SES, and 4.53 mm3 in PES. At follow-up, tissue volume increased at PP sites in both BMS and PES, but not after SES. Neointimal proliferation was similar between PP and non-PP sites. Stent thrombosis and restenosis rates were similar between PP and non-PP lesions.
  
  
  CONCLUSIONS
  The incidence of PP after implantation of new generation tubular stents in patients with diabetes remains high. Drug-eluting stent implantation was not associated with increased risk of PP. Plaque prolapse was not associated with stent thrombosis or increased neointimal proliferation.
authors.affiliation: Division of Cardiology and Cardiovascular Imaging Core Laboratories, University of Florida, Jacksonville, Florida 32209, USA.
authors.forename: Hideki
authors.initials: H
authors.lastname: Futamatsu
authors.forename: Manel
authors.initials: M
authors.lastname: Sabaté
authors.forename: Dominick J
authors.initials: DJ
authors.lastname: Angiolillo
authors.forename: Pilar
authors.initials: P
authors.lastname: Jimenez-Quevedo
authors.forename: Cecilia
authors.initials: C
authors.lastname: Corros
authors.forename: Kino
authors.initials: K
authors.lastname: Morikawa-Futamatsu
authors.forename: Fernando
authors.initials: F
authors.lastname: Alfonso
authors.forename: Julie
authors.initials: J
authors.lastname: Jiang
authors.forename: Pavel
authors.initials: P
authors.lastname: Cervinka
authors.forename: Rosana
authors.initials: R
authors.lastname: Hernandez-Antolin
authors.forename: Carlos
authors.initials: C
authors.lastname: Macaya
authors.forename: Theodore A
authors.initials: TA
authors.lastname: Bass
authors.forename: Marco A
authors.initials: MA
authors.lastname: Costa
mesh_terms: D000368:Aged; D002908:Chronic Disease; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000628:therapy; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000628:therapy; D003925:Diabetic Angiopathies / Q000000981:diagnostic imaging* / Q000628:therapy; D016503:Drug Delivery Systems / Q000009:adverse effects*; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008670:Metals; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D017239:Paclitaxel / Q000008:administration & dosage / Q000627:therapeutic use; D011391:Prolapse; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D020123:Sirolimus / Q000008:administration & dosage / Q000627:therapeutic use; D015607:Stents / Q000009:adverse effects*; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
chemical_list: D008670:Metals; D017239:Paclitaxel; D020123:Sirolimus