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Keimyung Medical Journal 2015;34(1):1-13.
Published online June 30, 2015.
Positive Peri-Stent Vascular Remodeling and Late-Acquired Incomplete Stent Apposition in Intravascular Ultrasound (IVUS) after Drug-Eluting Stent Implantation.
Hyo Eun Kim, Seung Ho Hur, Kwon Bae Kim, Yoon Nyun Kim, Seongwook Han, Hyungseop Kim, Hyuck Jun Yoon, Yun Kyeong Cho, Ki Bum Won, In Cheol Kim
Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea. shur@dsmc.or.kr
Abstract
The peri-stent vascular changes after 2nd generation drug-eluting stent (2G DES) implantation have not been fully investigated compare to 1st generation DES (1G DES). From March 2003 to October 2010, patients receiving percutaneous coronary intervention (PCI) with either 1G or 2G DES were retrospectively included. All patients underwent intravascular ultrasound (IVUS) at post-procedure and 8-12 months after PCI. A total of 281 patients (1G DES: 201 patients with 217 lesions and 2G DES: 80 patients with 88 lesions) were enrolled. The incidence of positive peri-stent vascular remodeling (PPVR) and late-acquired incomplete stent apposition (LAISA) were investigated by IVUS images. Major adverse cardiac events (MACE) up to 3 years were also evaluated. The lesion and the stent length were shorter, and the stent size was larger in the 2G DES group. The incidences of PPVR and LAISA were lower in the 2G DES group before and after propensity score matching. However, the incidence of 3-year MACE were not different between the two groups. Independent predictors for PPVR or LAISA were stent length and 1G DES implantation. These results suggested that biocompatible stent system in 2G DES might have reduced peri-stent vascular changes.
Key Words: Drug-eluting stents, Incomplete stent apposition, Intravascular ultrasound, Ischemic heart disease
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