Author + information
- Takashi Hiromasa,
- Shoichi Kuramitsu,
- Takenori Domei,
- Makoto Hyodo,
- Yoshimitsu Soga,
- Shinichi Shirai and
- Kenji Ando
Background: The PROMUS Element platinum-chromium everolimus-eluting stent (PtCr-EES) has a novel metal and stent design intended to improve deliverability, comformability, and radial strength, whereas such features might have the trade-off of reducing longitudinal stent strength, which would account for the occurrence of longitudinal stent deformation (LSD) as reported previously. However, the incidence and clinical impact of LSD after PtCr-EES implantation in clinical practice have not been fully evaluated.
Methods: A total of 809 patients with 1052 lesions undergoing PtCr-EES implantation between March 2012 and August 2013 were analyzed. LSD was defined as the distortion or shortening and elongation of a stent in the longitudinal axis following successful stent deployment. We assessed the incidence of longitudinal stent deformation and cumulative incidence of major adverse cardiac events (MACE), defined as a composite of cardiac death, non-fatal myocardial infarction, definite stent thrombosis, and clinically driven target lesion revascularization within 3-year.
Results: Of 809 patients with 1052 lesions, we performed an intravascular ultrasound (IVUS) and post-dilatation in 759 patients (93.8%) with 994 lesions (94.5%) and in 407 patients (50.6%) with 512 lesions (48.7%). LSD was observed in 20 patients (2.5%) with 20 lesions (1.9%). The mechanism of LSD was due to the following reasons: compression by post-dilatation balloons (n=4, 20.0%), entrapped IVUS (n=14, 70.0%) and pull backed jailed guide wire (n=2, 10.0%). At 3-year, the cumulative incidence of MACE, cardiac death, myocardial infarction, stent thrombosis and clinically driven target lesion revascularization were not significantly different between the LSD and non-LSD groups (17.2% vs. 10.6%, p=0.25; 0% vs. 3.1%, p=0.60; 5.6% vs. 4.8%, p=0.41; 0% vs. 1.0%, p=0.67; 17.2% vs. 7.3%, p=0.11, respectively).
Conclusions: LSD after PtCr-EES implantation occurs in 1.9% of lesions. However, LSD is not associated with MACE within 3-year.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Coronary Intervention in Interventional Cardiology: Core Concepts
Abstract Category: 21. Interventional Cardiology: Coronary Intervention: Devices
Presentation Number: 1286-176
- 2017 American College of Cardiology Foundation