| Intravascular ultrasound findings in patients with very late stent thrombosis after either drug-eluting or bare-metal stent implantation. | |
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MedLine Citation:
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PMID: 20430265 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: This study compared intravascular ultrasound (IVUS) findings at drug-eluting stent (DES) and bare-metal stent (BMS) sites in patients with very late stent thrombosis (VLST). BACKGROUND: VLST is being increasingly identified since the introduction of DES. VLST can also develop after BMS placement, but the underlying mechanisms remain unknown. METHODS: A total of 30 consecutive VLST patients with acute myocardial infarction (DES, n = 23; BMS, n = 7) were enrolled. Patients underwent IVUS examination before coronary angioplasty. RESULTS: The baseline characteristics were similar for the 2 groups, with the exception of reference vessel size, lesion length, stent length, minimal lumen diameter, and diameter stenosis after the procedure. Overall, VLST occurred at a mean 50.8 +/- 36.2 months after the index procedure, and occurred earlier after DES than BMS (33.2 +/- 12.5 months vs. 108.4 +/- 26.5 months, p < 0.001). IVUS variables were generally similar for the 2 groups. However, plaque burden at the distal reference segment, stent, and neointimal area of the in-stent segment were smaller in the DES group. Stent malapposition was observed in 73.9% of DES patients, but in no BMS patients (p = 0.001). Disease progression with neointimal rupture within the stent was observed in 10 DES patients (43.5%) and 7 BMS patients (100%; p = 0.010). CONCLUSIONS: Stent malapposition was unique to DES-related VLST, whereas disease progression with neointimal rupture was more common in BMS patients. These findings suggest that different biological mechanisms underlie VLST development depending upon the stent type. |
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Authors:
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Cheol Whan Lee; Su-Jin Kang; Duk-Woo Park; Seung-Hwan Lee; Young-Hak Kim; Jae-Joong Kim; Seong-Wook Park; Gary S Mintz; Seung-Jung Park |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of the American College of Cardiology Volume: 55 ISSN: 1558-3597 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 2010 May |
Date Detail:
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Created Date: 2010-04-30 Completed Date: 2010-05-13 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 1936-42 Citation Subset: AIM; IM |
Copyright Information:
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Copyright 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Medicine, Asan Medical Center, University of Ulsan, Seoul, Korea. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Angioplasty, Transluminal, Percutaneous Coronary / adverse effects Coronary Thrombosis / radiography, ultrasonography* Disease Progression Drug-Eluting Stents / adverse effects* Female Humans Male Middle Aged Myocardial Infarction / therapy*, ultrasonography Prosthesis Failure Stents / adverse effects* Time Factors Ultrasonography, Interventional |
| Comments/Corrections | |
Comment In:
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J Am Coll Cardiol. 2010 May 4;55(18):1943-4
[PMID:
20430266
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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