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AS-099 Stent Expansion after Additional Non-Compliant Balloon High Pressure Inflation in Patients with Drug-Eluting Stent Underexpansion: An Intravascular Ultrasound Study
Wednesday, April 27 - Friday April 29, 2011 (Poster Abstract Zone) receive more aggressive antithrombotic treatment however risk of bleeding and in-hospital outcome are comparable with BMS group.
AS-099 Stent Expansion after Additional Non-Compliant Balloon High Pressure Inflation in Patients with Drug-Eluting Stent Underexpansion: An Intravascular Ultrasound Study. Wang Soo Lee1, Sang Wook Kim1, Gary Mintz2, Young Joon Hong3, Sung Yun Lee4, Kwang Je Lee1, Tae Ho Kim1, Chee Jeong Kim1, Wang Seong Ryu1, August Pichard5, Neil Weissman5. 1Chung-Ang University Hospital, Seoul, Korea (Republic of); 2Cardiovascular Research Foundation, New York, Korea (Republic of); 3Chonnam National University Hospital, Gwangju, Korea (Republic of); 4Inje University Ilsan Pail Hospital, Ilsan, Korea (Republic of); 5 Washington Hospital Center, Washington, DC, Korea (Republic of).
P O S T E R A B S T R A C T S
Background: Stent underexpansion is one of the causes of drugeluting stent (DES) failure (restenosis and thrombosis). Methods: We used intravascular ultrasound (IVUS) to evaluate stent expansion in patients with DES underexpansion (minimal stent area [MSA] ⬍5mm2) in 52 lesions (50 pts) that had IVUS analysis before and after DES implantation. Additional non-compliant (NC) balloon high-pressure inflation (⬎18atm) was used, and post-NC balloon IVUS was repeated in all pts. Negative remodeling was defined as a remodeling index (lesion/reference arterial area) ⬍0.95. % stent expansion was defined as minimal stent area(MSA)/average reference lumen area. Results: Pt age was 62⫾10.4 yrs, and 19% were diabetic. Pre-DES the distal reference lumen area was 4.78⫾1.34mm2, minimal lumen area was 2.53⫾0.53mm2, and remodeling index was 0.98⫾0.08. MSA was increased after additional NC balloon inflation (p⫽0.004), and % stent expansion was improved (p⫽0.002); however, stent underexpansion still persisted as 56% (29/52) had a MSA ⬍90% of distal reference lumen and in 62% (32/52) the MSA was still ⬍5mm2.
AS-100 Late Regression of Sirolimus-Eluting Stent (SES) -Impact of Restenosis Pattern on Late Regression-. Shunsuke Kubo, Kazushige Kadota, Masatomo Ozaki, Nobuaki Yamauchi, Mitsuru Yoshino, Koshi Miyake, Haruki Eguchi, Noriyuki Ohashi, Yuki Hayakawa, Naoki Saito, Suguru Otsuru, Youji Okamoto, Mana Kusunose, Hiroshi Tasaka, Daiji Hasegawa, Yoshikazu Shigemoto, Seiji Habara, Tsuyoshi Tada, Hiroyuki Tanaka, Takeshi Maruo, Shingo Hosogi, Akitoshi Hirono, Yasushi Fuku, Naoki Oka, Hiroyuki Yamamoto, Hrumi Kato, Satoki Fujii, Tsuyoshi Goto, Kazuaki Mitsudo. Kurashiki Central Hospital, Kurashiki, Japan. Background: Late regression of bare-metal stent (BMS) has been reported. However, there are no data about late regression of sirolimuseluting stent (SES). Thus, we evaluated the late regression rate of SES comparing Bx velocity stent (BxS) which has the same platform. Methods: From November 2001 to December 2008, 5786 consecutive lesions were treated with SES and BxS (SES: 5492, BxS: 294 lesions) and were performed midterm follow-up coronary angiography (f/u CAG) at 6 to 8 months after implantation (f/u rate: 79.0% [4570/ 5786]). Of these lesions, 123 lesions (SES: 101, BxS: 22) of 432 restenosis lesions (SES: 366, BxS: 66) were not performed target lesion revascularization (TLR) and underwent late f/u CAG at 12 months after midterm f/u. The average percent stenosis of SES and BxS at midterm f/u were 57.6⫾9.4% and 59.8⫾10.5% (n.s.). We classified the restenosis pattern into focal and no-focal restenosis groups and evaluated the impact of restenosis pattern on late regression. The focal restenosis group included restenosis of stent edge or stent body. The nonfocal restenosis group included diffuse or multi-focal stenosis. We defined late regression as the regression from midterm f/u restenosis to late f/u nonrestenosis. Results: Data are shown in the table. - Late Regression Rate-
*: n.s. Conclusion: There was no difference in the prevalence of late regression between SES and BxS. As the restenosis pattern after SES implantation has an impact on late regression, it should be considered when performing TLR.
Conclusion: IVUS showed that DES underexpansion can be an unsolved problem even after additional high pressure NC balloon inflation.
72A
The American Journal of Cardiology姞 APRIL 27–29, 2011 ANGIOPLASTY SUMMIT ABSTRACTS/Poster
AS-099 Stent Expansion after Additional Non-Compliant Balloon High Pressure Inflation in Patients with Drug-Eluting Stent Underexpansion: An Intravascular Ultrasound Study. Wang Soo Lee1, Sang Wook Kim1, Gary Mintz2, Young Joon Hong3, Sung Yun Lee4, Kwang Je Lee1, Tae Ho Kim1, Chee Jeong Kim1, Wang Seong Ryu1, August Pichard5, Neil Weissman5. 1Chung-Ang University Hospital, Seoul, Korea (Republic of); 2Cardiovascular Research Foundation, New York, Korea (Republic of); 3Chonnam National University Hospital, Gwangju, Korea (Republic of); 4Inje University Ilsan Pail Hospital, Ilsan, Korea (Republic of); 5 Washington Hospital Center, Washington, DC, Korea (Republic of).
P O S T E R A B S T R A C T S
Background: Stent underexpansion is one of the causes of drugeluting stent (DES) failure (restenosis and thrombosis). Methods: We used intravascular ultrasound (IVUS) to evaluate stent expansion in patients with DES underexpansion (minimal stent area [MSA] ⬍5mm2) in 52 lesions (50 pts) that had IVUS analysis before and after DES implantation. Additional non-compliant (NC) balloon high-pressure inflation (⬎18atm) was used, and post-NC balloon IVUS was repeated in all pts. Negative remodeling was defined as a remodeling index (lesion/reference arterial area) ⬍0.95. % stent expansion was defined as minimal stent area(MSA)/average reference lumen area. Results: Pt age was 62⫾10.4 yrs, and 19% were diabetic. Pre-DES the distal reference lumen area was 4.78⫾1.34mm2, minimal lumen area was 2.53⫾0.53mm2, and remodeling index was 0.98⫾0.08. MSA was increased after additional NC balloon inflation (p⫽0.004), and % stent expansion was improved (p⫽0.002); however, stent underexpansion still persisted as 56% (29/52) had a MSA ⬍90% of distal reference lumen and in 62% (32/52) the MSA was still ⬍5mm2.
AS-100 Late Regression of Sirolimus-Eluting Stent (SES) -Impact of Restenosis Pattern on Late Regression-. Shunsuke Kubo, Kazushige Kadota, Masatomo Ozaki, Nobuaki Yamauchi, Mitsuru Yoshino, Koshi Miyake, Haruki Eguchi, Noriyuki Ohashi, Yuki Hayakawa, Naoki Saito, Suguru Otsuru, Youji Okamoto, Mana Kusunose, Hiroshi Tasaka, Daiji Hasegawa, Yoshikazu Shigemoto, Seiji Habara, Tsuyoshi Tada, Hiroyuki Tanaka, Takeshi Maruo, Shingo Hosogi, Akitoshi Hirono, Yasushi Fuku, Naoki Oka, Hiroyuki Yamamoto, Hrumi Kato, Satoki Fujii, Tsuyoshi Goto, Kazuaki Mitsudo. Kurashiki Central Hospital, Kurashiki, Japan. Background: Late regression of bare-metal stent (BMS) has been reported. However, there are no data about late regression of sirolimuseluting stent (SES). Thus, we evaluated the late regression rate of SES comparing Bx velocity stent (BxS) which has the same platform. Methods: From November 2001 to December 2008, 5786 consecutive lesions were treated with SES and BxS (SES: 5492, BxS: 294 lesions) and were performed midterm follow-up coronary angiography (f/u CAG) at 6 to 8 months after implantation (f/u rate: 79.0% [4570/ 5786]). Of these lesions, 123 lesions (SES: 101, BxS: 22) of 432 restenosis lesions (SES: 366, BxS: 66) were not performed target lesion revascularization (TLR) and underwent late f/u CAG at 12 months after midterm f/u. The average percent stenosis of SES and BxS at midterm f/u were 57.6⫾9.4% and 59.8⫾10.5% (n.s.). We classified the restenosis pattern into focal and no-focal restenosis groups and evaluated the impact of restenosis pattern on late regression. The focal restenosis group included restenosis of stent edge or stent body. The nonfocal restenosis group included diffuse or multi-focal stenosis. We defined late regression as the regression from midterm f/u restenosis to late f/u nonrestenosis. Results: Data are shown in the table. - Late Regression Rate-
*: n.s. Conclusion: There was no difference in the prevalence of late regression between SES and BxS. As the restenosis pattern after SES implantation has an impact on late regression, it should be considered when performing TLR.
Conclusion: IVUS showed that DES underexpansion can be an unsolved problem even after additional high pressure NC balloon inflation.
72A
The American Journal of Cardiology姞 APRIL 27–29, 2011 ANGIOPLASTY SUMMIT ABSTRACTS/Poster