Impact of postprocedure minimum stent area on long-term results following abciximab-coated stent implantation: an intravascular ultrasound analysis.
BACKGROUND
Smaller postprocedural minimum stent areas (MSA) measured by intravascular ultrasound (IVUS) have been associated with higher restenosis rates.


METHODS
This was a single-center, prospective, randomized trial and we assessed the predictive value of MSA for long-term patency and the incidence and extent of incomplete stent apposition (ISA) following abciximab-coated stent (n=69) compared to bare metal stent (BMS) implantation (n=69). All patients underwent IVUS follow-up at 6 months.


RESULTS
At follow-up coronary angiogram, the restenosis rate and late loss were 12%, 0.30+/-0.24 mm in abciximab-coated stent group and 29%, 0.68+/-0.36 mm in BMS group (p=0.011, 0.010, respectively). At follow-up IVUS, intrastent lumen area was significantly larger and intrastent neointimal hyperplasia area was significantly smaller in abciximab-coated stent group than those in BMS group (5.9+/-1.6 mm(2) vs. 4.5+/-1.7 mm(2), p=0.001, and 1.9+/-1.5 mm(2) vs. 3.3+/-1.9 mm(2), p<0.001, respectively). Target lesion revascularization occurred in 9%, 0%, and 0% in abciximab-coated stent group and 19%, 4%, and 1% in BMS group in lesions with a MSA <6.0 mm(2), from 6 to 7.5 mm(2), and >7.5 mm(2), respectively. Late-acquired ISA at follow-up was observed in 7 patients and there was no difference in the incidence of ISA between both groups [abciximab-coated stent: n=3 (4%) vs. BMS: n=4 (6%), p=0.698].


CONCLUSIONS
Abciximab-coated stent reduced restenosis and had a considerably lower optimal MSA threshold compared to BMS and showed lower incidence of late-acquired ISA.
Hong
Young Joon
YJ
The Heart Center of Chonnam National University Hospital, Chonnam National, University Research Institute of Medical Sciences, Gwangju, Republic of Korea.
Jeong
Myung Ho
MH
Hwang
Sun Ho
SH
Yun
Nam Sik
NS
Lim
Sang Yup
SY
Lee
Sang Rok
SR
Hong
Seo Na
SN
Kim
Kye Hun
KH
Park
Hyung Wook
HW
Kim
Ju Han
JH
Kim
Weon
W
Ahn
Young Keun
YK
Cho
Jeong Gwan
JG
Park
Jong Chun
JC
Kang
Jung Chaee
JC
D000077284:Abciximab; D000911:Antibodies, Monoclonal / Q000494:pharmacology*; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation*; D020099:Coated Materials, Biocompatible; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000000981:diagnostic imaging*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000494:pharmacology*; D011184:Postoperative Period; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015607:Stents; D013997:Time Factors; D018084:Ultrasonography, Interventional / Q000379:methods*
D000911:Antibodies, Monoclonal; D020099:Coated Materials, Biocompatible; D007140:Immunoglobulin Fab Fragments; D010975:Platelet Aggregation Inhibitors; D000077284:Abciximab