Published online before print May 17, 2004, doi: 10.1161/01.CIR.0000131890.83839.5B
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
(Circulation. 2004;109:2732-2736.)
© 2004 American Heart Association, Inc.
Clinical Investigation and Reports |
Intraprocedural Stent Thrombosis During Implantation of Sirolimus-Eluting Stents
From San Raffaele Hospital (A.C., R.R., F.A., G.W.M., M.M., I.M., M.C., A.C.) and Columbus Hospital (D.O., G.S., A.C.), Milan, and the Institute of Medical Statistics and Biometry, University of Milan (E.B.), Italy.
Correspondence to Antonio Colombo, MD, EMO Centro Cuore Columbus, Via M. Buonarroti 48, 20145 Milan, Italy. E-mail info{at}emocolumbus.it
Received September 29, 2003; de novo received December 29, 2003; revision received February 20, 2004; accepted February 25, 2004.
Background— Intraprocedural stent thrombosis (IPST) is a rare event (<0.01% in our experience with bare metal stents), with the exception of specific settings such as acute myocardial infarction, thrombus-containing lesions, and dissections. We report the occurrence of this event during elective implantation of sirolimus-eluting stents.
Methods and Results— Between April 2002 and August 2003, 670 patients with 1362 lesions were treated with Cypher (Cordis, Johnson and Johnson Co) sirolimus-eluting stent implantation in San Raffaele Hospital and EMO Centro Cuore Columbus. Diabetes mellitus was present in 142 patients (21%), and 164 (24.5%) had unstable angina. Pretreatment with glycoprotein IIb/IIIa (GP IIb/IIIa) inhibitors was carried out in 235 patients (35%). Total stent length per vessel was 42.9±28.3 mm. IPST occurred in 5 patients (0.7%). None of the patients with IPST were pretreated with GP IIb/IIIa inhibitors. Using univariate exact logistic regression, only total stent length per vessel, in millimeters (exact OR, 1.03; 95% CI, 1.011 to 1.046; P=0.0028), was associated with the occurrence of IPST.
Conclusions— Stent length was associated with the occurrence of IPST. Particular attention will need to be directed to this potential complication when long sirolimus-eluting stents are being used.
Key Words: stents • drugs • thrombosis
This article has been cited by other articles:
 |
|
 |
|
  X. Liu, H. Doi, A. Maehara, G. S. Mintz, J. de Ribamar Costa Jr, K. Sano, G. Weisz, G. D. Dangas, A. J. Lansky, E. M. Kreps, et al. A Volumetric Intravascular Ultrasound Comparison of Early Drug-Eluting Stent Thrombosis Versus Restenosis J. Am. Coll. Cardiol. Intv., May 1, 2009; 2(5): 428 - 434. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Chieffo, S.-J. Park, E. Meliga, I. Sheiban, M. S. Lee, A. Latib, Y.-H. Kim, M. Valgimigli, D. Sillano, V. Magni, et al. Late and very late stent thrombosis following drug-eluting stent implantation in unprotected left main coronary artery: a multicentre registry Eur. Heart J., September 1, 2008; 29(17): 2108 - 2115. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Chieffo, S. J. Park, M. Valgimigli, Y. H. Kim, J. Daemen, I. Sheiban, A. Truffa, M. Montorfano, F. Airoldi, G. Sangiorgi, et al. Favorable Long-Term Outcome After Drug-Eluting Stent Implantation in Nonbifurcation Lesions That Involve Unprotected Left Main Coronary Artery: A Multicenter Registry Circulation, July 10, 2007; 116(2): 158 - 162. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. F. Luscher, J. Steffel, F. R. Eberli, M. Joner, G. Nakazawa, F. C. Tanner, and R. Virmani Drug-Eluting Stent and Coronary Thrombosis: Biological Mechanisms and Clinical Implications Circulation, February 27, 2007; 115(8): 1051 - 1058. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Chieffo, N. Morici, F. Maisano, E. Bonizzoni, J. Cosgrave, M. Montorfano, F. Airoldi, M. Carlino, I. Michev, G. Melzi, et al. Percutaneous Treatment With Drug-Eluting Stent Implantation Versus Bypass Surgery for Unprotected Left Main Stenosis: A Single-Center Experience Circulation, May 30, 2006; 113(21): 2542 - 2547. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Hoye, I. Iakovou, L. Ge, C. A.G. van Mieghem, A. T.L. Ong, J. Cosgrave, G. M. Sangiorgi, F. Airoldi, M. Montorfano, I. Michev, et al. Long-Term Outcomes After Stenting of Bifurcation Lesions With the "Crush" Technique: Predictors of an Adverse Outcome J. Am. Coll. Cardiol., May 16, 2006; 47(10): 1949 - 1958. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Urban, A. H. Gershlick, G. Guagliumi, P. Guyon, C. Lotan, J. Schofer, A. Seth, J. E. Sousa, W. Wijns, C. Berge, et al. Safety of Coronary Sirolimus-Eluting Stents in Daily Clinical Practice: One-Year Follow-Up of the e-Cypher Registry Circulation, March 21, 2006; 113(11): 1434 - 1441. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. G.L. Biondi-Zoccai, P. Agostoni, G. M. Sangiorgi, F. Airoldi, J. Cosgrave, A. Chieffo, R. Barbagallo, C. Tamburino, G. Vittori, E. Falchetti, et al. Incidence, predictors, and outcomes of coronary dissections left untreated after drug-eluting stent implantation Eur. Heart J., March 1, 2006; 27(5): 540 - 546. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L Ge, I Iakovou, J Cosgrave, P Agostoni, F Airoldi, G M Sangiorgi, I Michev, A Chieffo, M Montorfano, M Carlino, et al. Treatment of bifurcation lesions with two stents: one year angiographic and clinical follow up of crush versus T stenting Heart, March 1, 2006; 92(3): 371 - 376. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Moreno, C. Fernandez, and C. Macaya Drug-eluting stent thrombosis: Results from a pooled analysis including 10 randomized studies: Reply J. Am. Coll. Cardiol., January 3, 2006; 47(1): 214 - 215. [Full Text] [PDF]
|
|
|
|
|
|
R. Moreno, C. Fernandez, and C. Macaya Drug-eluting stent thrombosis: Results from a pooled analysis including 10 randomized studies.REPLY J. Am. Coll. Cardiol., December 13, 2005; (2005) j.jacc.2005.10.015v1. [Full Text] [PDF]
|
|
|
|
|
|
L. Ge, F. Airoldi, I. Iakovou, J. Cosgrave, I. Michev, G. M. Sangiorgi, M. Montorfano, A. Chieffo, M. Carlino, N. Corvaja, et al. Clinical and Angiographic Outcome After Implantation of Drug-Eluting Stents in Bifurcation Lesions With the Crush Stent Technique: Importance of Final Kissing Balloon Post-Dilation J. Am. Coll. Cardiol., August 16, 2005; 46(4): 613 - 620. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Ge, I. Iakovou, J. Cosgrave, A. Chieffo, M. Montorfano, I. Michev, F. Airoldi, M. Carlino, G. Melzi, G. M. Sangiorgi, et al. Immediate and mid-term outcomes of sirolimus-eluting stent implantation for chronic total occlusions Eur. Heart J., June 1, 2005; 26(11): 1056 - 1062. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Tsagalou, A. Chieffo, I. Iakovou, L. Ge, G. M. Sangiorgi, N. Corvaja, F. Airoldi, M. Montorfano, I. Michev, and A. Colombo Multiple Overlapping Drug-Eluting Stents to Treat Diffuse Disease of the Left Anterior Descending Coronary Artery J. Am. Coll. Cardiol., May 17, 2005; 45(10): 1570 - 1573. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 I. Iakovou, T. Schmidt, E. Bonizzoni, L. Ge, G. M. Sangiorgi, G. Stankovic, F. Airoldi, A. Chieffo, M. Montorfano, M. Carlino, et al. Incidence, Predictors, and Outcome of Thrombosis After Successful Implantation of Drug-Eluting Stents JAMA, May 4, 2005; 293(17): 2126 - 2130. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. A. Bavry, D. J. Kumbhani, T. J. Helton, and D. L. Bhatt What is the risk of stent thrombosis associated with the use of paclitaxel-eluting stents for percutaneous coronary intervention?: A meta-analysis J. Am. Coll. Cardiol., March 15, 2005; 45(6): 941 - 946. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Moreno, C. Fernandez, R. Hernandez, F. Alfonso, D. J. Angiolillo, M. Sabate, J. Escaned, C. Banuelos, A. Fernandez-Ortiz, and C. Macaya Drug-eluting stent thrombosis: Results from a pooled analysis including 10 randomized studies J. Am. Coll. Cardiol., March 15, 2005; 45(6): 954 - 959. [Abstract] [Full Text] [PDF]
|
|