title: Impact of the distance from the stent edge to the residual plaque on edge restenosis following everolimus-eluting stent implantation.
abstract: OBJECTIVE
  This study aimed to assess the relation between stent edge restenosis (SER) and the distance from the stent edge to the residual plaque using quantitative intravascular ultrasound.
  
  
  BACKGROUND
  Although percutaneous coronary intervention with drug-eluting stents has improved SER rates, determining an appropriate stent edge landing zone can be challenging in cases of diffuse plaque lesions. It is known that edge vascular response can occur within 2 mm from the edge of a bare metal stent, but the distance to the adjacent plaque has not been evaluated for drug-eluting stents.
  
  
  METHODS
  A total of 97 proximal residual plaque lesions (plaque burden [PB] >40%) treated with everolimus-eluting stents were retrospectively evaluated to determine the distance from the stent edge to the residual plaque.
  
  
  RESULTS
  The SER group had significantly higher PB (59.1 ± 6.1% vs. 51.9 ± 9.1% for non-SER; P = 0.04). Higher PB was associated with SER, with the cutoff value of 54.74% determined using receiver operating characteristic (ROC) curve analysis. At this cutoff value of PB, the distance from the stent edge to the lesion was significantly associated with SER (odds ratio = 2.05, P = 0.035). The corresponding area under the ROC curve was 0.725, and the cutoff distance value for predicting SER was 1.0 mm.
  
  
  CONCLUSIONS
  An interval less than 1 mm from the proximal stent edge to the nearest point with the determined PB cutoff value of 54.74% was significantly associated with SER in patients with residual plaque lesions.
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan.
authors.forename: Masao
authors.initials: M
authors.lastname: Takahashi
authors.affiliation: Department of Medical Engineering, the University of Tokyo, Tokyo, Japan.
authors.forename: Susumu
authors.initials: S
authors.lastname: Miyazaki
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Myojo
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan.
authors.forename: Daigo
authors.initials: D
authors.lastname: Sawaki
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Iwata
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan.
authors.forename: Arihiro
authors.initials: A
authors.lastname: Kiyosue
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan.
authors.forename: Yasutomi
authors.initials: Y
authors.lastname: Higashikuni
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan.
authors.forename: Tomofumi
authors.initials: T
authors.lastname: Tanaka
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan.
authors.forename: Daishi
authors.initials: D
authors.lastname: Fujita
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan.
authors.forename: Jiro
authors.initials: J
authors.lastname: Ando
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan.
authors.forename: Hideo
authors.initials: H
authors.lastname: Fujita
authors.affiliation: Tokyo Teishin Hospital, Tokyo, Japan.
authors.forename: Yasunobu
authors.initials: Y
authors.lastname: Hirata
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan.
authors.forename: Issei
authors.initials: I
authors.lastname: Komuro
mesh_terms: D000368:Aged; D023903:Coronary Restenosis / Q000000981:diagnostic imaging* / Q000209:etiology*; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects*; D058226:Plaque, Atherosclerotic / Q000473:pathology*; D012372:ROC Curve; D012189:Retrospective Studies; D018084:Ultrasonography, Interventional