Document Detail


Intravascular ultrasound criteria for determination of optimal longitudinal positioning of sirolimus-eluting stents.
MedLine Citation:
PMID:  20534942     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Several studies have indicated that the clinical outcomes of sirolimus-eluting stents (SES) are significantly associated with longitudinal positioning of the stent relative to the underlying plaque distribution.
METHODS AND RESULTS: Optimal SES landing was determined using unique stepwise intravascular ultrasound (IVUS) criteria, mainly targeting the sites with plaque burden <50% (plaque area/external elastic membrane area x100). To verify the criteria, (1) achievability and (2) actual impact on clinical and angiographic outcomes were assessed. A total of 162 consecutive patients with 180 lesions were enrolled and treated according to the IVUS criteria. Plaque burden at the proximal and distal margins was 41.4+/-13.6% (n=144) and 34.9+/-15.6% (n=170), respectively (within 3 mm of stent ends). The target was achieved in 72.3% of the proximal and 84.1% of the distal margin for the criteria. A strikingly low angiographic margin re-stenosis rate (2.7% of proximal and 1.4% of distal margin) and low target lesion revascularization rate (2.2%) were achieved. Receiver operator characteristic curve indicated that plaque burden was the strongest predictor of margin re-stenosis and its threshold (51.6%) was almost identical to that of the criteria.
CONCLUSIONS: The proposed stepwise IVUS criteria mainly targeting plaque burden <50% are feasible and useful in the real-world practice of SES implantation.
Authors:
Yoshihiro Morino; Seiji Tamiya; Naoki Masuda; Yota Kawamura; Masakazu Nagaoka; Takashi Matsukage; Nobuhiko Ogata; Gaku Nakazawa; Teruhisa Tanabe; Yuji Ikari
Publication Detail:
Type:  Journal Article     Date:  2010-06-09
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  74     ISSN:  1347-4820     ISO Abbreviation:  Circ. J.     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-30     Completed Date:  2010-12-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  1609-16     Citation Subset:  IM    
Affiliation:
Division of Cardiology, Tokai University School of Medicine, Isehara 259-1193, Japan. ymorino@is.icc.u-tokai.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Aged
Drug-Eluting Stents*
Female
Humans
Male
Middle Aged
Plaque, Atherosclerotic
Prosthesis Implantation / methods*
Sirolimus / administration & dosage*
Ultrasonography, Interventional*
Chemical
Reg. No./Substance:
53123-88-9/Sirolimus

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