Kim Yong-Seok, Koo Bon-Kwon, Seo Jae-Bin, Park Kyung Woo, Suh Jung-Won, Lee Hae-Young, Park Jin-Shik, Kang Hyun-Jae, Cho Young-Seok, Chung Woo-Young, Chae In-Ho, Choi Dong-Ju, Kim Hyo-Soo, Oh Byung-Hee, Park Young-Bae
Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
Catheter Cardiovasc Interv. 2009 Jul 1;74(1):58-63. doi: 10.1002/ccd.21961.
The aim of this study was to evaluate the incidence and predictors of postprocedural incomplete stent apposition (ISA) after angiographically successful drug-eluting stent (DES) implantation.
The deployed stents are usually evaluated by angiography alone; however, there are possibilities of postprocedural ISA despite the angiographically successful implantation.
A total of 339 lesions in which poststent intravascular ultrasound (IVUS) was performed after successful DES implantation was included. Paclitaxel-eluting stents were implanted in 237 lesions and sirolimus-eluting stents (SES) in 102 lesions. Clinical, angiographic and procedural characteristics and IVUS findings for all cases were analyzed.
The overall incidence of ISA was 13.9% (47/339). By multivariate analysis, male gender (OR: 2.36, 95% CI: 1.09-5.11), deployment of SES (OR: 2.90, 95% CI: 1.49-5.67), the presence of intracoronary thrombus (OR: 7.47, 95% CI: 1.67-33.47), and non-ST elevation myocardial infarction (OR: 2.73, 95% CI: 1.09-6.83) were independent predictors for postprocedural ISA after angiographically successful DES implantation.
The incidence of postprocedural ISA after angiographically successful implantation of DES was not infrequent. A DES deployment strategy incorporating IVUS guidance might be helpful to reduce the incidence of postprocedural ISA.
