| A volumetric intravascular ultrasound comparison of early drug-eluting stent thrombosis versus restenosis. | |
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MedLine Citation:
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PMID: 19463466 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: We compared intravascular ultrasound findings of drug-eluting stent (DES)-treated lesions that developed thrombosis versus in-stent restenosis (ISR). BACKGROUND: Stent underexpansion is a predictor of both DES thrombosis and ISR. However, all underexpanded DES may not be equal. METHODS: Intravascular ultrasound findings from 20 definite DES thrombosis patients (representing all definite thromboses from 1,407 consecutive DES patients undergoing intravascular ultrasound imaging) were compared with 50 risk-factor-balanced ISR patients with no evidence of stent thrombosis and 50 risk-factor-balanced "no-event" patients with neither thrombosis nor ISR. RESULTS: Minimum stent area (3.9 +/- 1.0 mm(2) vs. 5.0 +/- 1.7 mm(2), p = 0.008), mean stent area (5.3 +/- 1.0 mm(2) vs. 7.2 +/- 2.0 mm(2), p = 0.001), and both focal (55.4 +/- 13.2% vs. 74.9 +/- 19.9%, p < 0.001) and diffuse stent expansion (77.4 +/- 19.3% vs. 109.5 +/- 23.1%, p < 0.001) were significantly smaller in the stent thrombosis group versus ISR and in both groups versus the "no-event" group. Minimum stent area <4.0 mm(2) (65% vs. 32%, p = 0.01) or <5.0 mm(2) (85% vs. 52%, p = 0.01) was more common in the stent thrombosis versus the ISR group and in both groups vs. "no-event" patients; and the relative length of the stent area <5 mm(2) was greatest in the stent thrombosis group (36.6 +/- 37.7%), intermediate in the ISR group (22.8 +/- 35.6%), and least in the "no-event" group (10.9 +/- 26.4%), p = 0.04. In the stent thrombosis group, the minimum stent area site occurred in the proximal stent segment in 50% versus 24% in the ISR group (p = 0.03). There were no differences in edge dissection, stent fracture, or stent-vessel-wall malapposition among the groups. CONCLUSIONS: The DES-treated lesions that develop thrombosis or restenosis are often underexpanded, but underexpansion associated with thrombosis is more severe, diffuse, and proximal in location. |
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Authors:
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Xuebo Liu; Hiroshi Doi; Akiko Maehara; Gary S Mintz; Jose de Ribamar Costa; Koichi Sano; Giora Weisz; George D Dangas; Alexandra J Lansky; Edward M Kreps; Michael Collins; Martin Fahy; Gregg W Stone; Jeffrey W Moses; Martin B Leon; Roxana Mehran |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: JACC. Cardiovascular interventions Volume: 2 ISSN: 1876-7605 ISO Abbreviation: JACC Cardiovasc Interv Publication Date: 2009 May |
Date Detail:
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Created Date: 2009-05-25 Completed Date: 2010-09-29 Revised Date: 2012-08-29 |
Medline Journal Info:
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Nlm Unique ID: 101467004 Medline TA: JACC Cardiovasc Interv Country: United States |
Other Details:
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Languages: eng Pagination: 428-34 Citation Subset: IM |
Affiliation:
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Columbia University Medical Center, New York, New York, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Analysis of Variance Aspirin / therapeutic use Coronary Restenosis / drug therapy, prevention & control*, ultrasonography Coronary Thrombosis / drug therapy, physiopathology, therapy*, ultrasonography Drug-Eluting Stents* Female Humans Male Middle Aged Retrospective Studies Risk Factors Ticlopidine / analogs & derivatives, therapeutic use Time Factors Ultrasonography, Interventional* |
| Chemical | |
Reg. No./Substance:
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50-78-2/Aspirin; 55142-85-3/Ticlopidine; 90055-48-4/clopidogrel |
| Comments/Corrections | |
Comment In:
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JACC Cardiovasc Interv. 2009 Aug;2(8):807
[PMID:
19695553
]
JACC Cardiovasc Interv. 2009 May;2(5):435-6 [PMID: 19463467 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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