title: Clinical and biomechanical behavior of a platinum-chromium stent platform in a large all-comer single-center population: insights from the Novara-PROMETEUS registry.
abstract: OBJECTIVE
  Longitudinal deformation has been described as a new complication affecting new-generation thin-strut coronary stents. Benchmark tests have suggested that the platinum-chromium (PtCr) Element coronary stent platform (Boston Scientific) might present increased susceptibility to this complication. Our study assessed the incidence of longitudinal stent deformation in a large single-center study population.
  
  
  RESULTS
  A total of 337 consecutive Promus Element PtCr stents deployed in an all-comer population underwent quantitative coronary angiography (QCA) analysis. Postdeployment QCA measured/nominal stent length ratio (SLR) was considered as a surrogate estimate of longitudinal stent deformation and averaged 0.95 ± 0.04 in the entire population. This small postdeployment reduction of stent length had no clinical relevance, leading to 3 cases (0.9%) of trivial geographical miss, which did not require further interventions. Plaque prolapse through the stent struts was observed in 19 cases (5.6%). Only 1 case of typical "concertina" effect (0.3%) complicated an ostial stenosis treatment requiring deployment of a second stent, while in 3 cases (0.9%), stent struts adapted to severely tortuous and calcified vessels mimicked longitudinal stent deformation, without further complications. Multiple regression analysis demonstrated a significant correlation between need for predilation and lower SLR values, while postdilation independently predicted higher SLR.
  
  
  CONCLUSIONS
  Systematic QCA analysis of a large single-center all-comers PCI population treated with PtCr stents failed to detect any clinically relevant longitudinal stent deformation. Complex lesions needing predilation were associated with a reduced SLR; conversely, postdilation was associated with QCA stent measures close to nominal. Clinicaltrials.gov ID: NCT01759719.
authors.affiliation: Cardiologia ospedaliera, Ospedale Maggiore della Carità, Cso Mazzini 18, 28100 Novara, Italy. lupialessandro1@tin.it.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Lupi
authors.forename: Italo
authors.initials: I
authors.lastname: Porto
authors.forename: Andrea
authors.initials: A
authors.lastname: Rognoni
authors.forename: Maurizio
authors.initials: M
authors.lastname: Lazzero
authors.forename: Rossella
authors.initials: R
authors.lastname: Fattori
authors.forename: Rosario
authors.initials: R
authors.lastname: Parisi
authors.forename: Giovanni Luigi
authors.initials: GL
authors.lastname: De Maria
authors.forename: Angelo Sante
authors.initials: AS
authors.lastname: Bongo
authors.forename: Imad
authors.initials: I
authors.lastname: Sheiban
authors.forename: Leonardo
authors.initials: L
authors.lastname: Bolognese
authors.forename: Pierfrancesco
authors.initials: P
authors.lastname: Agostoni
authors.forename: Gioel Gabrio
authors.initials: GG
authors.lastname: Secco
mesh_terms: D000368:Aged; D000792:Angiography; D001696:Biomechanical Phenomena; D002857:Chromium; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000628:therapy*; D004868:Equipment Failure / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D062645:Percutaneous Coronary Intervention / Q000295:instrumentation*; D010984:Platinum; D011446:Prospective Studies; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents
chemical_list: D002857:Chromium; D010984:Platinum