Restenosis and stent fracture following sirolimus-eluting stent (SES) implantation - A serial quantitative coronary angiography (QCA) and intravascular ultrasound (IVUS) study

Masanori Okumura, Yukio Ozaki, Junichi Ishii, Shino Kan, Hiroyuki Naruse, Shigeru Matsui, Makoto Ishikawa, Kousuke Hattori, Tomoko Gochi, Tadashi Nakano, Akira Yamada, Shigeru Kato, Sadako Motoyama, Masayoshi Sarai, Yasushi Takagi, Tevfik F. Ismail, Masanori Nomura, Hitoshi Hishida

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Abstract

Background: Restenosis still occurs, even with the sirolimus-eluting stent (SES), and the precise mechanisms and the impact of stent fracture on restensosis have not yet been elucidated. Methods and Results: Intravascular ultrasound (IVUS)-guided SES implantation was performed in 184 lesions in 151 patients with stable and unstable angina. Serial (pre-, post- and follow-up) quantitative coronary angiography analysis was obtained in 169 lesions in 138 patients (angiographic follow-up rate: 91%) and 12-month clinical follow-up was done in all patients. Restenosis occurred in 13 (7.7%) of 169 lesions. Stent fracture occurred in 4 (2.4%) of 169 lesions at follow-up. Of the 13 restenotic lesions, 8 had intimal hyperplasia, 4 had stent fracture, and 1 had late stent thrombosis at 7 months. Although multivariate logistic regression analysis revealed that minimal lumen area (min-LA) post (p=0.027), total stent length (p=0.003) and diabetes (p=0.032) were significant independent predictors of restenosis, univariate analysis showed that stent fracture was more common in the restenosis than in the non-restenosis groups (p=0.001). Conclusions: Although min-LA post by IVUS, total stent length by QCA and diabetes are independent predictors for angiographic restenosis, stent fracture occurred in 4 lesions (2.4%) and all of them resulted in restenosis (31% of the restenosis). The impact of stent fracture and its potential role in the development of restenosis deserves further study.

Original languageEnglish
Pages (from-to)1669-1677
Number of pages9
JournalCirculation Journal
Volume71
Issue number11
DOIs
Publication statusPublished - 17-12-2007

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Sirolimus
Coronary Angiography
Stents
Tunica Intima
Stable Angina
Unstable Angina
Hyperplasia
Thrombosis
Logistic Models
Regression Analysis

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Okumura, Masanori ; Ozaki, Yukio ; Ishii, Junichi ; Kan, Shino ; Naruse, Hiroyuki ; Matsui, Shigeru ; Ishikawa, Makoto ; Hattori, Kousuke ; Gochi, Tomoko ; Nakano, Tadashi ; Yamada, Akira ; Kato, Shigeru ; Motoyama, Sadako ; Sarai, Masayoshi ; Takagi, Yasushi ; Ismail, Tevfik F. ; Nomura, Masanori ; Hishida, Hitoshi. / Restenosis and stent fracture following sirolimus-eluting stent (SES) implantation - A serial quantitative coronary angiography (QCA) and intravascular ultrasound (IVUS) study. In: Circulation Journal. 2007 ; Vol. 71, No. 11. pp. 1669-1677.
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title = "Restenosis and stent fracture following sirolimus-eluting stent (SES) implantation - A serial quantitative coronary angiography (QCA) and intravascular ultrasound (IVUS) study",
abstract = "Background: Restenosis still occurs, even with the sirolimus-eluting stent (SES), and the precise mechanisms and the impact of stent fracture on restensosis have not yet been elucidated. Methods and Results: Intravascular ultrasound (IVUS)-guided SES implantation was performed in 184 lesions in 151 patients with stable and unstable angina. Serial (pre-, post- and follow-up) quantitative coronary angiography analysis was obtained in 169 lesions in 138 patients (angiographic follow-up rate: 91{\%}) and 12-month clinical follow-up was done in all patients. Restenosis occurred in 13 (7.7{\%}) of 169 lesions. Stent fracture occurred in 4 (2.4{\%}) of 169 lesions at follow-up. Of the 13 restenotic lesions, 8 had intimal hyperplasia, 4 had stent fracture, and 1 had late stent thrombosis at 7 months. Although multivariate logistic regression analysis revealed that minimal lumen area (min-LA) post (p=0.027), total stent length (p=0.003) and diabetes (p=0.032) were significant independent predictors of restenosis, univariate analysis showed that stent fracture was more common in the restenosis than in the non-restenosis groups (p=0.001). Conclusions: Although min-LA post by IVUS, total stent length by QCA and diabetes are independent predictors for angiographic restenosis, stent fracture occurred in 4 lesions (2.4{\%}) and all of them resulted in restenosis (31{\%} of the restenosis). The impact of stent fracture and its potential role in the development of restenosis deserves further study.",
author = "Masanori Okumura and Yukio Ozaki and Junichi Ishii and Shino Kan and Hiroyuki Naruse and Shigeru Matsui and Makoto Ishikawa and Kousuke Hattori and Tomoko Gochi and Tadashi Nakano and Akira Yamada and Shigeru Kato and Sadako Motoyama and Masayoshi Sarai and Yasushi Takagi and Ismail, {Tevfik F.} and Masanori Nomura and Hitoshi Hishida",
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Okumura, M, Ozaki, Y, Ishii, J, Kan, S, Naruse, H, Matsui, S, Ishikawa, M, Hattori, K, Gochi, T, Nakano, T, Yamada, A, Kato, S, Motoyama, S, Sarai, M, Takagi, Y, Ismail, TF, Nomura, M & Hishida, H 2007, 'Restenosis and stent fracture following sirolimus-eluting stent (SES) implantation - A serial quantitative coronary angiography (QCA) and intravascular ultrasound (IVUS) study', Circulation Journal, vol. 71, no. 11, pp. 1669-1677. https://doi.org/10.1253/circj.71.1669

Restenosis and stent fracture following sirolimus-eluting stent (SES) implantation - A serial quantitative coronary angiography (QCA) and intravascular ultrasound (IVUS) study. / Okumura, Masanori; Ozaki, Yukio; Ishii, Junichi; Kan, Shino; Naruse, Hiroyuki; Matsui, Shigeru; Ishikawa, Makoto; Hattori, Kousuke; Gochi, Tomoko; Nakano, Tadashi; Yamada, Akira; Kato, Shigeru; Motoyama, Sadako; Sarai, Masayoshi; Takagi, Yasushi; Ismail, Tevfik F.; Nomura, Masanori; Hishida, Hitoshi.

In: Circulation Journal, Vol. 71, No. 11, 17.12.2007, p. 1669-1677.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Restenosis and stent fracture following sirolimus-eluting stent (SES) implantation - A serial quantitative coronary angiography (QCA) and intravascular ultrasound (IVUS) study

AU - Okumura, Masanori

AU - Ozaki, Yukio

AU - Ishii, Junichi

AU - Kan, Shino

AU - Naruse, Hiroyuki

AU - Matsui, Shigeru

AU - Ishikawa, Makoto

AU - Hattori, Kousuke

AU - Gochi, Tomoko

AU - Nakano, Tadashi

AU - Yamada, Akira

AU - Kato, Shigeru

AU - Motoyama, Sadako

AU - Sarai, Masayoshi

AU - Takagi, Yasushi

AU - Ismail, Tevfik F.

AU - Nomura, Masanori

AU - Hishida, Hitoshi

PY - 2007/12/17

Y1 - 2007/12/17

N2 - Background: Restenosis still occurs, even with the sirolimus-eluting stent (SES), and the precise mechanisms and the impact of stent fracture on restensosis have not yet been elucidated. Methods and Results: Intravascular ultrasound (IVUS)-guided SES implantation was performed in 184 lesions in 151 patients with stable and unstable angina. Serial (pre-, post- and follow-up) quantitative coronary angiography analysis was obtained in 169 lesions in 138 patients (angiographic follow-up rate: 91%) and 12-month clinical follow-up was done in all patients. Restenosis occurred in 13 (7.7%) of 169 lesions. Stent fracture occurred in 4 (2.4%) of 169 lesions at follow-up. Of the 13 restenotic lesions, 8 had intimal hyperplasia, 4 had stent fracture, and 1 had late stent thrombosis at 7 months. Although multivariate logistic regression analysis revealed that minimal lumen area (min-LA) post (p=0.027), total stent length (p=0.003) and diabetes (p=0.032) were significant independent predictors of restenosis, univariate analysis showed that stent fracture was more common in the restenosis than in the non-restenosis groups (p=0.001). Conclusions: Although min-LA post by IVUS, total stent length by QCA and diabetes are independent predictors for angiographic restenosis, stent fracture occurred in 4 lesions (2.4%) and all of them resulted in restenosis (31% of the restenosis). The impact of stent fracture and its potential role in the development of restenosis deserves further study.

AB - Background: Restenosis still occurs, even with the sirolimus-eluting stent (SES), and the precise mechanisms and the impact of stent fracture on restensosis have not yet been elucidated. Methods and Results: Intravascular ultrasound (IVUS)-guided SES implantation was performed in 184 lesions in 151 patients with stable and unstable angina. Serial (pre-, post- and follow-up) quantitative coronary angiography analysis was obtained in 169 lesions in 138 patients (angiographic follow-up rate: 91%) and 12-month clinical follow-up was done in all patients. Restenosis occurred in 13 (7.7%) of 169 lesions. Stent fracture occurred in 4 (2.4%) of 169 lesions at follow-up. Of the 13 restenotic lesions, 8 had intimal hyperplasia, 4 had stent fracture, and 1 had late stent thrombosis at 7 months. Although multivariate logistic regression analysis revealed that minimal lumen area (min-LA) post (p=0.027), total stent length (p=0.003) and diabetes (p=0.032) were significant independent predictors of restenosis, univariate analysis showed that stent fracture was more common in the restenosis than in the non-restenosis groups (p=0.001). Conclusions: Although min-LA post by IVUS, total stent length by QCA and diabetes are independent predictors for angiographic restenosis, stent fracture occurred in 4 lesions (2.4%) and all of them resulted in restenosis (31% of the restenosis). The impact of stent fracture and its potential role in the development of restenosis deserves further study.

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DO - 10.1253/circj.71.1669

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