title: Relation of drug-eluting stent strut distribution to stent thrombosis in coronary arteries.
abstract: The distribution of stent struts is critical to drug deposition and, therefore, may affect the amount of neointima and the risk of thrombosis after drug-eluting stent (DES) implantation. The aim of our study was to evaluate stent strut distribution in the setting of a drug-eluting stent thrombosis (ST). We retrospectively analyzed postprocedural intravascular ultrasound (IVUS) images of 13 patients who subsequently developed ST (14 DES thrombotic lesions) and a control group of 27 patients (30 DES lesions) matched for stent type and presence of chronic renal failure. In addition to standard IVUS measurements, visible struts were counted and maximum interstrut angle was measured at 1-mm intervals. Early ST was defined as < or =30 days after DES deployment and late ST as >30 days after DES deployment. Compared with DES controls, the ST group had a larger maximum interstrut angle (60.8 +/- 8.3 degrees vs 55.7 +/- 4.8 degrees , p = 0.014) and a similar number of stent struts (8.4 +/- 0.6 vs 8.7 +/- 0.6, p = NS). Maximum interstrut angle tended to be larger in late ST than in early ST (66.1 +/- 10.8 degrees vs 57.8 +/- 5.0 degrees , p = 0.071). The incidence of maximum interstrut angles > or =90 degrees and > or =120 degrees observed continuously for > or =2 mm of stent length was higher in the ST group (p = 0.009 and p = 0.096, respectively). In conclusion, DES-treated lesions leading to ST had larger maximum interstrut gaps distributed circumferentially and longitudinally, but a similar number of struts at the time of DES implantation compared with DES controls.
authors.affiliation: Cardiovascular Research Institute, Washington Hospital Center, Washington, DC, USA.
authors.forename: Maksymilian P
authors.initials: MP
authors.lastname: Opolski
authors.forename: Radoslaw
authors.initials: R
authors.lastname: Pracon
authors.forename: Gary S
authors.initials: GS
authors.lastname: Mintz
authors.forename: Teruo
authors.initials: T
authors.lastname: Okabe
authors.forename: Jerzy
authors.initials: J
authors.lastname: Pregowski
authors.forename: Sung Yun
authors.initials: SY
authors.lastname: Lee
authors.forename: Eva C
authors.initials: EC
authors.lastname: van der Waal
authors.forename: Lukasz
authors.initials: L
authors.lastname: Kalinczuk
authors.forename: Probal
authors.initials: P
authors.lastname: Roy
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Smith
authors.forename: Rebecca
authors.initials: R
authors.lastname: Torguson
authors.forename: Zhenyi
authors.initials: Z
authors.lastname: Xue
authors.forename: Lowell F
authors.initials: LF
authors.lastname: Satler
authors.forename: Kenneth M
authors.initials: KM
authors.lastname: Kent
authors.forename: Augusto D
authors.initials: AD
authors.lastname: Pichard
authors.forename: Ron
authors.initials: R
authors.lastname: Waksman
authors.forename: Neil J
authors.initials: NJ
authors.lastname: Weissman
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D017023:Coronary Angiography; D003328:Coronary Thrombosis / Q000000981:diagnostic imaging* / Q000209:etiology*; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional