Post-intervention IVUS is not predictive for very late in-stent thrombosis in drug-eluting stents
| Autor: | Van der Bom Jg, Frits R. Rosendaal, Liem Ss, Jukema Jw, Martin J. Schalij, Sandrin C. Bergheanu, Ayman K.M. Hassan, Jouke Dijkstra, Van der Hoeven Bl |
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| Rok vydání: | 2009 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors medicine.medical_treatment Myocardial Infarction Coronary Angiography Sudden death Post-intervention Electrocardiography Predictive Value of Tests medicine Humans cardiovascular diseases Myocardial infarction Stent thrombosis Angioplasty Balloon Coronary Ultrasonography Interventional Aged 80 and over Aspirin business.industry Coronary Thrombosis Stent Drug-Eluting Stents General Medicine Middle Aged equipment and supplies medicine.disease Thrombosis Prosthesis Failure surgical procedures operative Female Radiology Cardiology and Cardiovascular Medicine Complication business Follow-Up Studies medicine.drug |
| Zdroj: | Acta Cardiologica. 64:611-616 |
| ISSN: | 0001-5385 |
| DOI: | 10.2143/ac.64.5.2042690 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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