Author + information
- Received November 10, 2004
- Revision received December 14, 2004
- Accepted December 21, 2004
- Published online April 5, 2005.
- Kenichi Fujii, MD,
- Stéphane G. Carlier, MD, PhD⁎ (, )
- Gary S. Mintz, MD,
- Yi-ming Yang, MD,
- Issam Moussa, MD,
- Giora Weisz, MD,
- George Dangas, MD, PhD,
- Roxana Mehran, MD,
- Alexandra J. Lansky, MD,
- Edward M. Kreps, MD,
- Michael Collins, MD,
- Gregg W. Stone, MD,
- Jeffrey W. Moses, MD and
- Martin B. Leon, MD
- ↵⁎Reprint requests and correspondence:
Dr. Stéphane G. Carlier, Cardiovascular Research Foundation, Intravascular Imaging and Physiology, 55 East 59th Street, 6th floor, New York, New York 10022
Objectives We sought to determine the predictors of stent thrombosis after sirolimus-eluting stent (SES) implantation.
Background A number of cases of stent thrombosis have been reported after commercial release of the SES in the “real world,” such that the U.S. Food and Drug Administration issued a warning.
Methods Fifteen patients who developed stent thrombosis after successful SES implantation were analyzed and compared with 45 matched control patients who had no evidence of stent thrombosis.
Results Minimum stent cross-sectional area (MSA) (4.3 ± 1.6 mm2vs. 6.2 ± 1.9 mm2, p < 0.001) and stent expansion (0.65 ± 0.18 vs. 0.85 ± 0.14, p < 0.001) were significantly smaller in the stent thrombosis group than in the matched control patients. There was no significant difference in the rate of SES malapposition between the groups. However, the presence of a significant residual reference segment stenosis was more common in the stent thrombosis group compared with the matched control group (67% vs. 9%, p < 0.001). Independent predictors of stent thrombosis were stent underexpansion (p = 0.03) and a significant residual reference segment stenosis (p = 0.02).
Conclusions Stent underexpansion and residual reference segment stenosis are associated with stent thrombosis after successful SES implantation.
- Received November 10, 2004.
- Revision received December 14, 2004.
- Accepted December 21, 2004.
- American College of Cardiology Foundation