title: Impact of stent platform on longitudinal stent deformation: an in vivo frequency domain optical coherence tomography study.
abstract: Recently, longitudinal coronary stent deformation has been highlighted as a possible cause of drug-eluting stent failure. Although bench tests and in vivo studies have demonstrated difference in longitudinal stent strength among the stents with different platforms, its clinical impact is still unknown. Furthermore, it is unknown if modified stent platform favorably affect the incidence of stent deformation. The aim of this study was to investigate the longitudinal deformation of the everolimus-eluting stents (EES) with different stent platforms by using frequency domain optical coherence tomography (FD-OCT). Seventy-eight lesions treated with EES (Xience Prime: n = 26, Promus element: n = 29, Promus premier: n = 23) were studied. After successful stent implantation, FD-OCT was performed and stent length was measured using three-dimensional reconstruction of the images in vivo. Percent longitudinal stent shortening (%SS) was defined as the in vivo stent length divided by nominal stent length. Longitudinal stent deformation was defined as  %SS > 10 %. Patients' and procedural characteristics were similar among 3 EESs. There was no difference in mean  %SS between Xience Prime, Promus Element and Promus Premier (1.0 ± 5.8, 2.9 ± 6.7 and 0.8 ± 3.7 %, p = 0.322). Incidence of the longitudinal stent deformation was significantly higher in Promus Element than the other stents (0, 13.8 and 0 %, p = 0.028). Incidence of longitudinal stent deformation was different between EESs with different stent platforms. Stent material, stent design and/or stent delivery balloon may affect longitudinal stent deformation.
authors.affiliation: Division of Cardiology, Kawasaki Medical School, 577 Matsushima, Kurashiki, 701-0192, Japan. ryotaro@med.kawasaki-m.ac.jp.
authors.forename: Ryotaro
authors.initials: R
authors.lastname: Yamada
authors.affiliation: Division of Cardiology, Kawasaki Medical School, 577 Matsushima, Kurashiki, 701-0192, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Okura
authors.affiliation: Division of Cardiology, Kawasaki Medical School, 577 Matsushima, Kurashiki, 701-0192, Japan.
authors.forename: Teruyoshi
authors.initials: T
authors.lastname: Kume
authors.affiliation: Division of Cardiology, Kawasaki Medical School, 577 Matsushima, Kurashiki, 701-0192, Japan.
authors.forename: Kenzo
authors.initials: K
authors.lastname: Fukuhara
authors.affiliation: Division of Cardiology, Kawasaki Medical School, 577 Matsushima, Kurashiki, 701-0192, Japan.
authors.forename: Terumasa
authors.initials: T
authors.lastname: Koyama
authors.affiliation: Division of Cardiology, Kawasaki Medical School, 577 Matsushima, Kurashiki, 701-0192, Japan.
authors.forename: Tomitaka
authors.initials: T
authors.lastname: Higa
authors.affiliation: Division of Cardiology, Kawasaki Medical School, 577 Matsushima, Kurashiki, 701-0192, Japan.
authors.forename: Yoji
authors.initials: Y
authors.lastname: Neishi
authors.affiliation: Department of Cardiology, The Sakakibara Heart Institute of Okayama, Okayama, Japan.
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Yoshida
authors.affiliation: Division of Cardiology, Kawasaki Medical School, 577 Matsushima, Kurashiki, 701-0192, Japan.
authors.forename: Shiro
authors.initials: S
authors.lastname: Uemura
mesh_terms: D000368:Aged; D000787:Angina Pectoris / Q000601:surgery; D001807:Blood Vessel Prosthesis / Q000009:adverse effects; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000379:methods; D054855:Drug-Eluting Stents / Q000009:adverse effects; D019544:Equipment Failure Analysis; D000068338:Everolimus / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008137:Longitudinal Studies; D008297:Male; D011475:Prosthesis Failure; D015641:Radiography, Interventional; D041623:Tomography, Optical Coherence
chemical_list: D007166:Immunosuppressive Agents; D000068338:Everolimus
keywords: Deformation; Drug-eluting stent fracture; Optical coherence tomography