Stent underexpansion and residual reference segment stenosis are related to stent thrombosis after sirolimus-eluting stent implantation: An intravascular ultrasound study

Kenichi Fujii, Stéphane G. Carlier, Gary S. Mintz, Yi Ming Yang, Issam Moussa, Giora Weisz, George Dangas, Roxana Mehran, Alexandra J. Lansky, Edward M. Kreps, Michael Collins, Gregg W. Stone, Jeffrey W. Moses, Martin B. Leon

Research output: Contribution to journalArticlepeer-review

612 Scopus citations

Abstract

OBJECTIVES: We sought to determine the predictors of stent thrombosis after sirolimus-eluting stent (SES) implantation. BACKGROUND: A number of cases of stent thrombosis have been reported after commercial release of the SES in the "real world," such that the U.S. Food and Drug Administration issued a warning. METHODS: Fifteen patients who developed stent thrombosis after successful SES implantation were analyzed and compared with 45 matched control patients who had no evidence of stent thrombosis. RESULTS: Minimum stent cross-sectional area (MSA) (4.3 ± 1.6 mm2 vs. 6.2 ± 1.9 mm2, p < 0.001) and stent expansion (0.65 ± 0.18 vs. 0.85 ± 0.14, p < 0.001) were significantly smaller in the stent thrombosis group than in the matched control patients. There was no significant difference in the rate of SES malapposition between the groups. However, the presence of a significant residual reference segment stenosis was more common in the stent thrombosis group compared with the matched control group (67% vs. 9%, p < 0.001). Independent predictors of stent thrombosis were stent underexpansion (p = 0.03) and a significant residual reference segment stenosis (p = 0.02). CONCLUSIONS: Stent underexpansion and residual reference segment stenosis are associated with stent thrombosis after successful SES implantation.

Original languageEnglish (US)
Pages (from-to)995-998
Number of pages4
JournalJournal of the American College of Cardiology
Volume45
Issue number7
DOIs
StatePublished - Apr 1 2005
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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