"Angiographic late catch-up" phenomenon after sirolimus-eluting stent implantation.


BACKGROUND Although several randomized trials have shown that sirolimus-eluting stent (SES) substantially reduces in-stent restenosis, recent studies have suggested the possibility of late catch-up after SES implantation. We investigated long-term angiographic outcomes after SES implantation in real-world practice. METHODS This study was conducted on 195 patients with 253 lesions who underwent the first and long-term angiographic follow-up after SES implantation. First follow-up was done at near 6 months after SES implantation. Long-term angiographic follow-up was defined as that performed at least 36 months after index procedure. Angiographies in patients who experienced target lesion revascularization at the time of the first angiographic follow-up were excluded from the current analysis. RESULTS Minimal luminal diameter at long-term angiographic follow-up was significantly smaller compared with that at the first follow-up (2.21 ± 0.65 vs. 2.40 ± 0.55, p<0.001). In-stent late lumen loss between the first and long-term follow-up tended to be larger compared with that between SES implantation and the first follow-up (0.19 ± 0.47 vs. 0.15 ± 0.39, p=0.298). There was a trend for increased incidence of coronary artery aneurysm (1.6% and 7.5% at the first and long-term follow-up) and stent fracture (4.3% and 10.3%). Two stent aneurysms and one stent fracture were related with definite very late stent thrombosis. CONCLUSION An "angiographic late catch-up" phenomenon and a trend toward increased incidence of coronary artery aneurysm and stent fracture were found at a median 46.5-month angiographic follow-up compared with a median 6-month follow-up.

DOI: 10.1016/j.ijcard.2011.03.024


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@article{Yang2012AngiographicLC, title={"Angiographic late catch-up" phenomenon after sirolimus-eluting stent implantation.}, author={Tae-hyun Yang and Doo-il Kim and Han-Young Jin and Young-Wan Cho and Sang Ryul Chung and Dong-Kie Kim and Y Kim and Jae-Sik Jang and Ung Kim and Sang-hoon Seol and Dae-Kyeong Kim and Dong-Soo Kim}, journal={International journal of cardiology}, year={2012}, volume={160 1}, pages={48-52} }