[Intravascular ultrasound assessment of sirolimus-eluting stent restenosis or thrombosis after stent implantation].
OBJECTIVE
To identify underlying mechanical risk factors of that developed in-stent restenosis (ISR) or early stent thrombosis in sirolimus-eluting stent (SES)-treated lesions using intravascular ultrasound (IVUS).


METHODS
IVUS were performed in 60 (ISR, n = 43; early stent thrombosis, n = 17) patients (event group) and in 34 patients without ISR and early stent thrombosis (no-event group) underwent SES implantations.


RESULTS
Compared with the no-event group, minimum stent area [MSA, (4.6 +/- 1.6) mm(2) vs. (5.8 +/- 1.6) mm(2), P < 0.01], minimum stent diameter [(2.2 +/- 0.5) mm vs. (2.5 +/- 0.4) mm, P < 0.01], and stent expansion [(69.2 +/- 20.7)% vs. (80.6 +/- 17.2)%, P < 0.01] were significantly smaller, and longitudinal stent symmetry index (MSA/maximum stent area, 2.0 +/- 0.6 vs. 1.7 +/- 0.6, P < 0.05) was significantly larger in the event group. Incidence of MSA < 4.0 mm(2) (43.3% vs. 14.7%, P < 0.01) and stent expansion < 60% (40.7% vs. 11.8%, P < 0.01) were more frequent in the event group than that in no-event group. Furthermore, proximal residual plaque burden was significantly higher compared to the no-event group [(49.0 +/- 15.5)% vs. (38.4 +/- 17.6)%, P < 0.01]. Independent predictors of post SES ISR or early thrombosis were MSA (OR:0.7, 95%CI:0.5 - 0.8, P < 0.01) and proximal residual plaque burden (OR: 280.7, 95%CI: 17.2 - 40 583.6, P < 0.01).


CONCLUSIONS
Smaller MSA and higher proximal residual plaque burden are independent predictors of ISR or early thrombosis post SES implantations.
Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China.
Xue-bo
XB
Liu
Ju-ying
JY
Qian
Feng
F
Zhang
Lei
L
Ge
Dong
D
Huang
Bing
B
Fan
Qi-bing
QB
Wang
Jun-bo
JB
Ge
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects; D015331:Cohort Studies; D023903:Coronary Restenosis / Q000000981:diagnostic imaging* / Q000209:etiology; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020123:Sirolimus / Q000008:administration & dosage; D013927:Thrombosis / Q000000981:diagnostic imaging* / Q000209:etiology; D018084:Ultrasonography, Interventional
D020123:Sirolimus