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.
Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
Yong-Seok
YS
Kim
Bon-Kwon
BK
Koo
Jae-Bin
JB
Seo
Kyung Woo
KW
Park
Jung-Won
JW
Suh
Hae-Young
HY
Lee
Jin-Shik
JS
Park
Hyun-Jae
HJ
Kang
Young-Seok
YS
Cho
Woo-Young
WY
Chung
In-Ho
IH
Chae
Dong-Ju
DJ
Choi
Hyo-Soo
HS
Kim
Byung-Hee
BH
Oh
Young-Bae
YB
Park
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