Document Detail


Impact of hinge motion on in-stent restenosis after sirolimus-eluting stent implantation.
MedLine Citation:
PMID:  21628832     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: A tortuous lesion with hinge motion is reportedly a risk factor for in-stent restenosis (ISR) after bare metal stent implantation. Sirolimus-eluting stents (SESs) implantation has dramatically reduced ISR. However, SES is a closed-cell design stent, which has low conformability and flexibility. Several studies have reported a relationship between tortuous lesions and stent fracture, which is one of the causes of ISR. The efficacy of SES in a tortuous lesion with hinge motion has not been fully evaluated. The aim of this study was to investigate the relationship between tortuous lesions and ISR after SES implantation.
METHODS AND RESULTS: Three year clinical follow-up data after SES implantation, including 6-9 month scheduled follow-up coronary angiography in 399 consecutive patients with 537 lesions, were obtained. Δangle was defined as the difference in the angle of the target lesion between the diastole and systole before the procedure. The incidence of ISR was 8.2%. The mean maximal angle and Δangle were larger in the ISR group (47 ± 22° vs. 37 ± 21°, P=0.004 and 20 ± 13° vs. 13 ± 10°, P < 0.0001, respectively). Independent predictors of ISR were Δangle, hemodialysis, aortic ostium stenting, and diabetes mellitus. Hinge motion-associated ISR (Δangle ≥ 16°) occurred in 28 lesions: stent fracture in 9, stent recoil in 6, edge injury in 10, and others in 3.
CONCLUSIONS: The amount of hinge motion in tortuous lesions should be considered in the selection of drug eluting stent types.
Authors:
Yasushi Ino; Takashi Kubo; Hironori Kitabata; Kunihiro Shimamura; Yasutsugu Shiono; Makoto Orii; Keishi Okochi; Hiromichi Sougawa; Takashi Tanimoto; Kenichi Komukai; Kohei Ishibashi; Shigeho Takarada; Hiroko Nakanishi; Atsushi Tanaka; Keizo Kimura; Kumiko Hirata; Masato Mizukoshi; Toshio Imanishi; Takashi Akasaka
Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2011-05-31
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  75     ISSN:  1347-4820     ISO Abbreviation:  Circ. J.     Publication Date:  2011  
Date Detail:
Created Date:  2011-07-25     Completed Date:  2011-11-18     Revised Date:  2012-01-09    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  1878-84     Citation Subset:  IM    
Affiliation:
Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan.
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MeSH Terms
Descriptor/Qualifier:
Aged
Diabetes Complications / epidemiology,  pathology
Drug-Eluting Stents*
Female
Follow-Up Studies
Graft Occlusion, Vascular / epidemiology*,  etiology*,  pathology*
Humans
Male
Middle Aged
Motion*
Renal Dialysis / adverse effects
Risk Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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