The possibility of delayed arterial healing 5 years after implantation of sirolimus-eluting stents: Serial observations by coronary angioscopy - 06/08/11
, Masamichi Takano, MD a, d, Daisuke Murakami, MD a, Toru Inami, MD a, Nobuaki Kobayashi, MD a, Sigenobu Inami, MD b, Kentaro Okamatsu, MD a, Takayoshi Ohba, MD a, Chikao Ibuki, MD a, Noritake Hata, MD a, Yoshihiko Seino, MD a, Ik-Kyung Jang, MD c, Kyoichi Mizuno, MD bRiassunto |
Background |
Although very late stent thrombosis occurs several years after implantation of sirolimus-eluting stent (SES), the morphologic changes of the stent beyond 2 years have not yet been systematically studied in living patients. The late vascular response to SES was therefore evaluated by serial angioscopic studies at 2 and 5 years after stent implantation.
Methods |
A total of 17 patients with 17 SES underwent a repeated angioscopy procedure at 2 and 5 years. Neointimal stent coverage (NSC) was classified as follows: grade 0, presence of uncovered struts; grade 1, visible struts through a thin neointima; or grade 2, complete neointimal coverage without visible struts. For each patient, the minimum and maximum NSC grade and the existence of in-stent thrombus were recorded.
Results |
The minimum and maximum NSC grade did not increase between the 2 and 5 years (0.59 ± 0.51 vs 0.88 ± 0.70, P = .17, and 1.82 ± 0.39 vs 1.94 ± 0.24, P = .30, respectively). The prevalence of patients with uncovered struts did not significantly decrease from 2 to 5 years (41% vs 29%, P = .49). During the follow-up period, 3 of 6 thrombi disappeared, whereas new thrombus formation was found in 3 patients without any clinical symptoms. In-stent thrombus did not decrease (35% vs 35%, P > .99).
Conclusions |
The current serial angioscopic study suggests that incomplete NSC and the prevalence of latent thrombus within the SES segments did not decrease from 2 to 5 years. The risk of stent thrombosis related to incomplete healing of SES may continue for an extended period.
Il testo completo di questo articolo è disponibile in PDF.Mappa
Vol 161 - N° 6
P. 1200-1206 - Giugno 2011 Ritorno al numero
Articolo precedente
- New insights by optical coherence tomography into the differences and similarities of culprit ruptured plaque morphology in non–ST-elevation myocardial infarction and ST-elevation myocardial infarction
- Konstantinos Toutouzas, Antonios Karanasos, Eleftherios Tsiamis, Maria Riga, Maria Drakopoulou, Andreas Synetos, Aggelos Papanikolaou, Costas Tsioufis, Aris Androulakis, Elli Stefanadi, Dimitrios Tousoulis, Christodoulos Stefanadis
- Safety and efficacy of femoral vascular closure devices in patients undergoing primary percutaneous coronary intervention for ST-elevation myocardial infarction
- Óscar Prada-Delgado, Rodrigo Estévez-Loureiro, Ramón Calviño-Santos, Eduardo Barge-Caballero, Jorge Salgado-Fernández, Pablo Piñón-Esteban, Jose Manuel Vázquez-Rodríguez, Guillermo Aldama-López, Xacobe Flores-Ríos, María Rita Soler-Martín, Nicolás Vázquez-González, Alfonso Castro-Beiras
Benvenuto su EM|consulte, il riferimento dei professionisti della salute.
L'accesso al testo integrale di questo articolo richiede un abbonamento.
Già abbonato a @@106933@@ rivista ?