Intravascular ultrasound assessment of sirolimus-eluting stent restenosis or thrombosis after stent implantation
10.3760/cma.j.issn.0253-3758.2009.05.004
- VernacularTitle:血管内超声评价雷帕霉素洗脱支架再狭窄及早期血栓形成
- Author:
Xue-Bo LIU
1
;
Ju-Ying QIAN
;
Feng ZHANG
;
Lei GE
;
Dong HUANG
;
Bing FAN
;
Qi-Bing WANG
;
Jun-Bo GE
Author Information
1. 复旦大学附属中山医院
- Keywords:
Coronary disease;
Stents;
UhrasonogTaphy,interventional
- From:
Chinese Journal of Cardiology
2009;37(5):397-401
- CountryChina
- Language:Chinese
-
Abstract:
Objective To identify underlying mechanical risk factors of that developed in-stent restenosis (ISR) or early stent thrombosis in sirolimus-eluting stent (SES)-treated lesions using intravascular ultrasound (IVUS). Methods IVUS were performed in 60 (ISR, n = 43; early stent thrombosis, n = 17) patients (event group) and in 34 patients without ISR and early stent thrombosis (noevent group) underwent SES implantations. Results Compared with the no-event group, minimum stent area [MSA, (4.6±1.6) mm2 vs. (5.8±1.6) mm2, P ＜0.01], minimum stent diameter [(2.2±0.5) mm vs. (2.5±0.4) mm, P＜0.01],andstentexpansion[(69.2±20.7)% vs. (80.6±17.2)%,P＜ 0.01] were significantly smaller, and longitudinal stent symmetry index (MSA/maximum stent area, 2.0±0.6 vs. 1.7±0.6, P ＜ 0.05) was significantly larger in the event group. Incidence of MSA ＜ 4.0 mm2(43.3% vs. 14.7%, P ＜0.01) and stent expansion ＜60% (40.7% vs. 11.8%, P ＜0.01) were more frequent in the event group than that in no-event group. Furthermore, proximal residual plaque burden was significantly higher compared to the no-event group [(49.0±15.5) % vs. (38.4±17.6) %, P ＜ 0.01]. Independent predictors of post SES 1SR or early thrombosis were MSA (OR:0.7, 95% CI:0.5-0.8, P ＜ 0.01) and proximal residual plaque burden (OR:280.7, 95% CI: 17.2-40 583.6, P ＜ 0.01). Conclusion Smaller MSA and higher proximal residual plaque burden are independent predictors of ISR or early thrombosis post SES implantations.
