TY - JOUR
T1 - Intravascular ultrasound findings of stent fractures in patients with sirolimus- and paclitaxel-eluting stents
AU - Doi, Hiroshi
AU - Maehara, Akiko
AU - Mintz, Gary S.
AU - Tsujita, Kenichi
AU - Kubo, Takashi
AU - Castellanos, Celia
AU - Lansky, Alexandra J.
AU - Witzenbichler, Bernhard
AU - Guagliumi, Giulio
AU - Brodie, Bruce
AU - Kellett, Mirle A.
AU - Parise, Helen
AU - Mehran, Roxana
AU - Leon, Martin B.
AU - Moses, Jeffrey W.
AU - Stone, Gregg W.
N1 - Funding Information:
Drs. Lansky, Parise, Mintz report being employed by the Cardiovascular Research Foundation, New York, New York. Drs. Leon and Stone are members of the advisory boards for Boston Scientific Corporation, Boston, Massachusetts and Abbott Vascular, Santa Clara, California. Drs. Mintz and Guagliumi are consultants for Volcano Corporation, Rancho Cordova, California. Drs. Moses and Guagliumi are consultants for Boston Scientific Corporation. Drs. Maehara, Mintz, Lansky, Guagliumi, and Stone reports receiving research grants from Boston Scientific Corporation . Drs. Maehara, Mintz, and Lansky reports receiving research grants from Volcano Corporation . Drs. Witzenbicher and Mehran report receiving lecture fees from Boston Scientific Corporation, Abbott Vascular, and the Medicines Company. Dr.Brodie reports receiving lecture fees from Medicines Company and MedRad/Possis.
Funding Information:
Dr. Maehara reports receiving research grants from Boston Scientific , Fremont, California, and Volcano, Rancho Cordova , California. Dr. Guagliumi reports grant support from Medtronic , Minneapolis, Minnesota, and Boston Scientific . Dr. Stone reports receiving grant support from Boston Scientific , the Medicines Company , Parsippany, New Jersey, and Abbott Vascular , Santa Clara, California. HORIZONS-AMI Trial was sponsored by the Cardiovascular Research Foundation, with grant support from Boston Scientific and the Medicines Company .
PY - 2010/10/1
Y1 - 2010/10/1
N2 - We compared intravascular ultrasound (IVUS) findings of fractures of sirolimus-eluting stents (SESs) versus paclitaxel-eluting stents (PESs). IVUS findings in 6 PES fractures (all in the right coronary artery) in 6 patients from a clinical trial cohort were compared to 14 SES fractures (8 in the right coronary artery, 2 in the left anterior descending coronary artery, and 4 in the left circumflex coronary artery) in 13 patients from our institutional cohort. Comparing PES fractures to SES fractures, IVUS analysis showed (1) similar frequency of complete stent fracture (1 of 6, 17%, vs 3 of 14, 21%, p >0.99), (2) similar frequency of fracture adjacent to calcified plaque or stent metal overlap (5 of 6, 86%, vs 14 of 14, 100%, p = 0.99), (3) more frequent complete malalignment of proximal and distal fragments in PES strut fractures compared to SES fractures (5 of 6, 83%, vs 1 of 14, 7%, p = 0.002), (4) similar stent lengths (45.2 mm, 23.8 to 50.7, vs 39.3 mm, 22.6 to 73.4, p >0.99), (5) similar fracture lengths (0.5 mm, 0.4 to 0.7, vs 0.7 mm, 0.6 to 1.0, p = 0.14), and (6) larger reference external elastic membrane area (15.0 mm2, 13.5 to 18.0, vs 10.4 mm2, 6.8 to 13.6, p = 0.01). In conclusion, malalignment of proximal and distal stent fragments more often occurred in PES fractures compared to SES fractures; otherwise the IVUS features of PES and SES fractures were similar.
AB - We compared intravascular ultrasound (IVUS) findings of fractures of sirolimus-eluting stents (SESs) versus paclitaxel-eluting stents (PESs). IVUS findings in 6 PES fractures (all in the right coronary artery) in 6 patients from a clinical trial cohort were compared to 14 SES fractures (8 in the right coronary artery, 2 in the left anterior descending coronary artery, and 4 in the left circumflex coronary artery) in 13 patients from our institutional cohort. Comparing PES fractures to SES fractures, IVUS analysis showed (1) similar frequency of complete stent fracture (1 of 6, 17%, vs 3 of 14, 21%, p >0.99), (2) similar frequency of fracture adjacent to calcified plaque or stent metal overlap (5 of 6, 86%, vs 14 of 14, 100%, p = 0.99), (3) more frequent complete malalignment of proximal and distal fragments in PES strut fractures compared to SES fractures (5 of 6, 83%, vs 1 of 14, 7%, p = 0.002), (4) similar stent lengths (45.2 mm, 23.8 to 50.7, vs 39.3 mm, 22.6 to 73.4, p >0.99), (5) similar fracture lengths (0.5 mm, 0.4 to 0.7, vs 0.7 mm, 0.6 to 1.0, p = 0.14), and (6) larger reference external elastic membrane area (15.0 mm2, 13.5 to 18.0, vs 10.4 mm2, 6.8 to 13.6, p = 0.01). In conclusion, malalignment of proximal and distal stent fragments more often occurred in PES fractures compared to SES fractures; otherwise the IVUS features of PES and SES fractures were similar.
UR - http://www.scopus.com/inward/record.url?scp=77956974104&partnerID=8YFLogxK
U2 - 10.1016/j.amjcard.2010.05.024
DO - 10.1016/j.amjcard.2010.05.024
M3 - Article
C2 - 20854956
AN - SCOPUS:77956974104
SN - 0002-9149
VL - 106
SP - 952
EP - 957
JO - American Journal of Cardiology
JF - American Journal of Cardiology
IS - 7
ER -