Impact of final stent dimensions on long-term results following sirolimus-eluting stent implantation
| Autor: | Junya Ako, Mitsuyasu Terashima, Richard E. Kuntz, Ali Hassan, Heidi N. Bonneau, Yasuhiro Honda, Shinjo Sonoda, Paul G. Yock, Martin B. Leon, Jeffrey W. Moses, Yoshihiro Morino, Peter J. Fitzgerald |
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| Rok vydání: | 2004 |
| Předmět: |
medicine.medical_specialty
medicine.diagnostic_test business.industry medicine.medical_treatment education Lumen (anatomy) Stent equipment and supplies medicine.disease Coronary artery disease Restenosis Internal medicine Angioplasty Predictive value of tests Intravascular ultrasound medicine Cardiology Radiology business Cardiology and Cardiovascular Medicine Antibacterial agent |
| Zdroj: | Journal of the American College of Cardiology. 43(11):1959-1963 |
| ISSN: | 0735-1097 |
| DOI: | 10.1016/j.jacc.2004.01.044 |
| Popis: | Objectives We assessed the predictive value of minimum stent area (MSA) for long-term patency of sirolimus-eluting stents (SES) implantation compared to bare metal stents (BMS). Background Although MSA is a consistent predictor of in-stent restenosis, its predictive value in BMS is still limited because of biologic variability in the restenosis process. Methods From the SIRolImUS (SIRIUS) trial, 122 cases (SES: 72; BMS: 50) with complete serial intravascular ultrasound (IVUS) (baseline and 8-month follow-up) were analyzed. Postprocedure MSA and follow-up minimum lumen area (MLA) were obtained. Based on previous physiologic studies, adequate stent patency at follow-up was defined as MLA >4 mm2. Results In both groups, a significant positive correlation was observed between baseline MSA and follow-up MLA (SES: p < 0.0001, BMS: p < 0.0001). However, SES showed higher correlation than BMS (0.8 vs. 0.65) with a higher regression coefficient (0.92 vs. 0.59). The sensitivity and specificity curves identified different optimal thresholds of MSA to predict adequate follow-up MLA: 5 mm2for SES and 6.5 mm2for BMS. The positive predictive values with these cutoff points were 90% and 56%, respectively. Conclusions In this SIRIUS IVUS substudy, SES reduced both biologic variability and restenosis, resulting in increased predictability of long-term stent patency with postprocedure MSA. In addition, SES had a considerably lower optimal MSA threshold compared to BMS. |
| Databáze: | OpenAIRE |
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