| Frequency and determinants of black holes in sirolimus-eluting stent restenosis. | |
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MedLine Citation:
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PMID: 16877780 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: In-stent neointimal hyperplasia typically has a homogenous echoreflective appearance during intravascular ultrasound (IVUS) imaging. However, the neointimal hyperplasia of some brachytherapy failure lesions contains a very echolucent, dark zone that has been termed black hole. We sought to investigate the frequency and determinants of black holes (BH) after sirolimus-eluting stent (SES) implantation. METHODS: A prospective, consecutive series of 33 intrastent SES restenosis (> 50% neointimal hyperplasia with a minimal lumen area < 4.0 mm2) was studied with IVUS. Patients were divided into 2 groups: 8 patients with BH versus 25 patients without BH. RESULTS: Fifty percent of the BH cases occurred in saphenous vein graft lesions. BH tissue was noticed in 8% of all patients with in-stent restenosis. Three patients in each group had previous vascular brachytherapy failure (p = 0.1). Compared to non-BH cases, a greater proportion of BH cases occurred after SES treatment of bare-metal stent restenosis (75% vs. 32%; p = 0.035). BH cases presented earlier (89.9 +/- 34.3 vs. 161.3 +/- 78.8 days; p = 0.001) with more severe in-stent restenosis, as indicated by greater absolute and relative amounts of neointimal hyperplasia (41.3 +/- 10.0 vs. 26.9 +/- 19.5 mm3; p = 0.012, and 19.6 +/- 6.8 vs. 10.4 +/- 7.9%; p = 0.0001, respectively). CONCLUSIONS: Echolucent restenotic tissue (black hole) is more often observed in SES restenosis after treatment of saphenous vein graft lesions or treatment of bare-metal stent restenosis. It occurs earlier and is more severe than typical SES failures. |
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Authors:
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Jose de Ribamar Costa; Gary S Mintz; Stéphane G Carlier; Kenichi Fujii; Koichi Sano; Masashi Kimura; Kaoru Tanaka; Joanna Lui; Jeffrey W Moses; Martin B Leon |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The Journal of invasive cardiology Volume: 18 ISSN: 1557-2501 ISO Abbreviation: J Invasive Cardiol Publication Date: 2006 Aug |
Date Detail:
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Created Date: 2006-07-31 Completed Date: 2006-09-08 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8917477 Medline TA: J Invasive Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 348-52 Citation Subset: IM |
Affiliation:
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Cardiovascular Research Foundation and Columbia University Medical Center, New York, New York, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Coronary Restenosis / epidemiology*, etiology, ultrasonography Coronary Stenosis / therapy* Equipment Design Female Graft Occlusion, Vascular / therapy Humans Incidence Male Metals Middle Aged Prospective Studies Saphenous Vein / transplantation Sirolimus / administration & dosage* Stents / adverse effects* Ultrasonography, Interventional |
| Chemical | |
Reg. No./Substance:
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0/Metals; 53123-88-9/Sirolimus |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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