Document Detail


Post-intervention IVUS is not predictive for very late in-stent thrombosis in drug-eluting stents.
MedLine Citation:
PMID:  20058506     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Stent thrombosis is a life-threatening complication associated with sudden death and acute myocardial infarction. Histopathologic studies have linked the occurrence of very late stent thrombosis in drug-eluting stents (DES) with delayed endothealisation and stent malapposition. Our aim was to investigate if late stent malapposition in DES could be predicted by immediate postintervention intra-vascular ultrasonography (IVUS). METHODS AND RESULTS: From our MISSION! database of 184 consecutive patients with ST-elevation myocardial infarction (STEMI) who had immediate post-intervention and nine-month follow-up IVUS examinations we prospectively identified three patients with very late (> 365 days) and definite (with angiographic evidence) in-stent thrombosis in DES. Patients had completed the twelve-month clopidogrel-aspirin dual treatment period, two of them were under aspirin therapy while the third patient had aspirin temporarily discontinued before planned surgery. When assessed by serial documentary (immediate post-intervention and nine-month) IVUS, all three patients demonstrated stent malapposition at nine months: in two cases the malapposition was acquired (immediate post-intervention IVUS showed a well apposed stent) and one case presented persistent malapposition (the stent was found malapposed both at immediate post-intervention and nine-month follow-up IVUS). CONCLUSIONS: Immediate post-intervention IVUS showing no malapposition does not guarantee an uneventful course after DES implantation.
Authors:
Sandrin C Bergheanu; Bas L Van der Hoeven; Ayman K M Hassan; Jouke Dijkstra; Frits R Rosendaal; Su-San Liem; Martin J Schalij; Johanna G Van der Bom; J Wouter Jukema
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Acta cardiologica     Volume:  64     ISSN:  0001-5385     ISO Abbreviation:  Acta Cardiol     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2010-01-11     Completed Date:  2010-02-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370570     Medline TA:  Acta Cardiol     Country:  Belgium    
Other Details:
Languages:  eng     Pagination:  611-6     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged, 80 and over
Angioplasty, Transluminal, Percutaneous Coronary / adverse effects*
Coronary Angiography
Coronary Thrombosis / etiology,  radiography,  ultrasonography*
Drug-Eluting Stents / adverse effects*
Electrocardiography
Female
Follow-Up Studies
Humans
Male
Middle Aged
Myocardial Infarction / diagnosis,  surgery*
Predictive Value of Tests
Prosthesis Failure
Time Factors
Ultrasonography, Interventional / methods*

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