Intravascular ultrasound findings of stent fractures in patients with Sirolimus- and Paclitaxel-eluting stents.
We compared intravascular ultrasound (IVUS) findings of fractures of sirolimus-eluting stents (SESs) versus paclitaxel-eluting stents (PESs). IVUS findings in 6 PES fractures (all in the right coronary artery) in 6 patients from a clinical trial cohort were compared to 14 SES fractures (8 in the right coronary artery, 2 in the left anterior descending coronary artery, and 4 in the left circumflex coronary artery) in 13 patients from our institutional cohort. Comparing PES fractures to SES fractures, IVUS analysis showed (1) similar frequency of complete stent fracture (1 of 6, 17%, vs 3 of 14, 21%, p >0.99), (2) similar frequency of fracture adjacent to calcified plaque or stent metal overlap (5 of 6, 86%, vs 14 of 14, 100%, p = 0.99), (3) more frequent complete malalignment of proximal and distal fragments in PES strut fractures compared to SES fractures (5 of 6, 83%, vs 1 of 14, 7%, p = 0.002), (4) similar stent lengths (45.2 mm, 23.8 to 50.7, vs 39.3 mm, 22.6 to 73.4, p >0.99), (5) similar fracture lengths (0.5 mm, 0.4 to 0.7, vs 0.7 mm, 0.6 to 1.0, p = 0.14), and (6) larger reference external elastic membrane area (15.0 mm(2), 13.5 to 18.0, vs 10.4 mm(2), 6.8 to 13.6, p = 0.01). In conclusion, malalignment of proximal and distal stent fragments more often occurred in PES fractures compared to SES fractures; otherwise the IVUS features of PES and SES fractures were similar.
Doi
Hiroshi
H
Cardiovascular Research Foundation/Columbia University Medical Center, New York, New York, USA.
Maehara
Akiko
A
Mintz
Gary S
GS
Tsujita
Kenichi
K
Kubo
Takashi
T
Castellanos
Celia
C
Lansky
Alexandra J
AJ
Witzenbichler
Bernhard
B
Guagliumi
Giulio
G
Brodie
Bruce
B
Kellett
Mirle A
MA
Parise
Helen
H
Mehran
Roxana
R
Leon
Martin B
MB
Moses
Jeffrey W
JW
Stone
Gregg W
GW
D000972:Antineoplastic Agents, Phytogenic / Q000627:therapeutic use*; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D004868:Equipment Failure; D005260:Female; D006801:Humans; D008297:Male; D017239:Paclitaxel / Q000627:therapeutic use*; D020123:Sirolimus / Q000627:therapeutic use*; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
D000972:Antineoplastic Agents, Phytogenic; D017239:Paclitaxel; D020123:Sirolimus