The incidence and predictors of postprocedural incomplete stent apposition after angiographically successful drug-eluting stent implantation.
OBJECTIVE
The aim of this study was to evaluate the incidence and predictors of postprocedural incomplete stent apposition (ISA) after angiographically successful drug-eluting stent (DES) implantation.


BACKGROUND
The deployed stents are usually evaluated by angiography alone; however, there are possibilities of postprocedural ISA despite the angiographically successful implantation.


METHODS
A total of 339 lesions in which poststent intravascular ultrasound (IVUS) was performed after successful DES implantation was included. Paclitaxel-eluting stents were implanted in 237 lesions and sirolimus-eluting stents (SES) in 102 lesions. Clinical, angiographic and procedural characteristics and IVUS findings for all cases were analyzed.


RESULTS
The overall incidence of ISA was 13.9% (47/339). By multivariate analysis, male gender (OR: 2.36, 95% CI: 1.09-5.11), deployment of SES (OR: 2.90, 95% CI: 1.49-5.67), the presence of intracoronary thrombus (OR: 7.47, 95% CI: 1.67-33.47), and non-ST elevation myocardial infarction (OR: 2.73, 95% CI: 1.09-6.83) were independent predictors for postprocedural ISA after angiographically successful DES implantation.


CONCLUSIONS
The incidence of postprocedural ISA after angiographically successful implantation of DES was not infrequent. A DES deployment strategy incorporating IVUS guidance might be helpful to reduce the incidence of postprocedural ISA.
Kim
Yong-Seok
YS
Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
Koo
Bon-Kwon
BK
Seo
Jae-Bin
JB
Park
Kyung Woo
KW
Suh
Jung-Won
JW
Lee
Hae-Young
HY
Park
Jin-Shik
JS
Kang
Hyun-Jae
HJ
Cho
Young-Seok
YS
Chung
Woo-Young
WY
Chae
In-Ho
IH
Choi
Dong-Ju
DJ
Kim
Hyo-Soo
HS
Oh
Byung-Hee
BH
Park
Young-Bae
YB
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation*; D002317:Cardiovascular Agents / Q000008:administration & dosage; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000628:therapy*; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D017239:Paclitaxel / Q000008:administration & dosage; D011237:Predictive Value of Tests; D011474:Prosthesis Design; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D020123:Sirolimus / Q000008:administration & dosage; D017211:Treatment Failure; D018084:Ultrasonography, Interventional
D002317:Cardiovascular Agents; D017239:Paclitaxel; D020123:Sirolimus