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Comparison of intravascular ultrasonic imaging with versus without incomplete stent apposition at follow-up after drug-eluting stent implantation

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Abstract

Background Incomplete stent apposition (ISA) at follow-up has been reported to be more common after drug-eluting stent (DES) implantation than after bare-metal stent (BMS) implantation. The aim of this study was to use intravascular ultrasound (IVUS) to evaluate the coronary characteristics after drug-eluting stent implantation in patients with ISA at follow-up. Methods From the IVUS database of our institute, a total of 89 patients with 125 native lesions who underwent DES implantation into de novo lesions with IVUS imaging at 6-month follow-up were identified, and 15 (16.9%) patients had documented ISA at follow-up by IVUS. The ISA group was compared with a matched control group of patients (n = 30) who had no evidence of ISA at follow-up. Results Of the 15 documented ISA at follow-up after DES implantation, two located at the edge (within 5 mm from stent margin) while 13 in the body of the stent. The maximum area and arc of ISA measured 5.3 ± 2.2 mm2 and 163 ± 67°, respectively. In patients with ISA, the maximum EEM area of stent segment with ISA was significantly larger than the adjacent stent segment without ISA (24.1 ± 3.3 vs. 20.1 ± 3.1 mm2, P = 0.002), while stent area, plaque plus media (P&M) area and intrastent lumen area were comparable (P > 0.05). Compared to the matched control cohort without ISA at follow-up, the maximum EEM area was also significantly larger (24.1 ± 3.3 vs. 18.8 ± 4.2 mm2, P < 0.001), while the areas of reference EEM and lumen, stent, P&M behind the stent, intimal hyperplasia and intrastent lumen were all comparable between the two groups (P > 0.05). Conclusion ISA at follow-up after DES implantation for de novo coronary lesions was associated with a larger EEM area.

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Acknowledgments

This study was supported by the young scientist fund from Shanghai municipal health bureau (2006Y15).

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Authors and Affiliations

  1. Department of Cardiology, Zhongshan Hospital, Shanghai Institute of Cardiovascular Diseases, Fudan University, 180 Fenglin Road, Shanghai, 200032, China

    Juying Qian, Feng Zhang, Hongyi Wu, Bing Fan, Lei Ge & Junbo Ge

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  1. Juying Qian
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  2. Feng Zhang
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  3. Hongyi Wu
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  4. Bing Fan
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  5. Lei Ge
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  6. Junbo Ge
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Correspondence to Junbo Ge.

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Juying Qian, Feng Zhang contributed equally to this manuscript.

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Qian, J., Zhang, F., Wu, H. et al. Comparison of intravascular ultrasonic imaging with versus without incomplete stent apposition at follow-up after drug-eluting stent implantation. Int J Cardiovasc Imaging 24, 133–139 (2008). https://doi.org/10.1007/s10554-007-9249-1

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  • DOI: https://doi.org/10.1007/s10554-007-9249-1

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