title: Intravascular ultrasound findings of stent fractures in patients with Sirolimus- and Paclitaxel-eluting stents.
abstract: 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.
authors.affiliation: Cardiovascular Research Foundation/Columbia University Medical Center, New York, New York, USA.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Doi
authors.forename: Akiko
authors.initials: A
authors.lastname: Maehara
authors.forename: Gary S
authors.initials: GS
authors.lastname: Mintz
authors.forename: Kenichi
authors.initials: K
authors.lastname: Tsujita
authors.forename: Takashi
authors.initials: T
authors.lastname: Kubo
authors.forename: Celia
authors.initials: C
authors.lastname: Castellanos
authors.forename: Alexandra J
authors.initials: AJ
authors.lastname: Lansky
authors.forename: Bernhard
authors.initials: B
authors.lastname: Witzenbichler
authors.forename: Giulio
authors.initials: G
authors.lastname: Guagliumi
authors.forename: Bruce
authors.initials: B
authors.lastname: Brodie
authors.forename: Mirle A
authors.initials: MA
authors.lastname: Kellett
authors.forename: Helen
authors.initials: H
authors.lastname: Parise
authors.forename: Roxana
authors.initials: R
authors.lastname: Mehran
authors.forename: Martin B
authors.initials: MB
authors.lastname: Leon
authors.forename: Jeffrey W
authors.initials: JW
authors.lastname: Moses
authors.forename: Gregg W
authors.initials: GW
authors.lastname: Stone
mesh_terms: 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
chemical_list: D000972:Antineoplastic Agents, Phytogenic; D017239:Paclitaxel; D020123:Sirolimus