Author + information
- Jeffrey J. Popma,
- Alexandra Almonacid,
- Dean Kereiakes,
- Ian Meredith,
- Paul Teirstein,
- Dominic Allocco,
- Keith D. Dawkins and
- Gregg Stone
Distortion of native vessel geometry after coronary stenting has been associated with reduced coronary flow velocity and shear stress, increased stent fracture, impaired vessel healing, and late restenosis. Greater stent conformability may minimize vessel distortion and improve early and late coronary flow. This analysis examines the impact of stent design on vessel straightening in severely angulated lesions.
The PLATINUM trial randomized 1530 patients with 1 or 2 de novo native coronary artery lesions (baseline vessel diameter ≥2.50 mm to ≤4.25 mm and length ≤24 mm) to receive the PROMUS Element Everolimus Eluting Stent (EES; Boston Scientific) or the XIENCE V EES (Abbott Vascular). A post hoc angiographic analysis of the 100 (N=50 PROMUS Element, N=50 XIENCE V) most severely angulated lesions (highest baseline bend) was conducted. Vessel angulation (degrees) and curvature (mm–1) immediately before and after stent implantation was measured by a blinded, independent angiographic core laboratory using three dimensional quantitative angiographic software (CAAS 3D, Pie Medical Imaging, The Netherlands).
The average change in angulation was significantly lower in the PROMUS Element group than the XIENCE V group (Table).
Despite longer lesion length, there was less distortion of vessel architecture with PROMUS Element compared to XIENCE V. Further study of the clinical implications of this finding (e.g., stent fracture, restenosis) is needed.
|Factor||XIENCE V (N=50 Lesions)||PROMUS Element (N=50 Lesions)||P Value|
|Lesion Length, mm||12.4±5.7||15.2±6.2||0.020|
|Stent Length, mm||19.4±10.4||22.0±7.5||0.159|
|Baseline Bend, degrees (at min MLD)||79.1±13.5||79.0±11.7||0.969|
|Pre-Procedure Angulation, degrees|
|Post-Procedure Angulation, degrees|
|Change in Angulation, degrees|
|Curvature Difference (mm-1)|
Poster Sessions, Expo North
Saturday, March 09, 2013, 10:00 a.m.–10:45 a.m.
Session Title: Coronary Stents
Abstract Category: 47. TCT@ACC–i2: Coronary Intervention, Devices
Presentation Number: 2101–229
- 2013 American College of Cardiology Foundation