Intraprocedural Stent Thrombosis During Implantation of Sirolimus-Eluting Stents

Chieffo, Alaide; Bonizzoni, Erminio; Orlić, Dejan; Stanković, Goran; Rogacka, Renata; Airoldi, Flavio; Mikhail, Ghada; Montorfano, Matteo; Michev, Iassen; Carlino, Mauro; Colombo, Antonio

doi:10.1161/01.cir.0000131890.83839.5b

Cited by 87 publications

(48 citation statements)

References 22 publications

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“…This fact stresses the importance of careful screening of each patient before considering PCI to rule out any risk of premature discontinuation of antiplatelet therapy. 21,22 One persisting problem is for how long the patients need to continue double-antiplatelet therapy. In this series, almost 70% of the patients were still taking 2 antiplatelet agents at 1 year.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Treatment With Drug-Eluting Stent Implantation Versus Bypass Surgery for Unprotected Left Main Stenosis

et al. 2006

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Section: Discussionmentioning

confidence: 99%

Percutaneous Treatment With Drug-Eluting Stent Implantation Versus Bypass Surgery for Unprotected Left Main Stenosis

et al. 2006

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“…With BMS, reported rates of stent thrombosis have ranged between 0.5% and 2.8%, 14,16,23,24 whereas with drug-eluting stents (DES), rates have ranged between 0% and 3.5% in randomized trials 1,[25][26][27] and between 0.4% and 1.6% in registries. 9,13,15,28,29 The definition of stent thrombosis used in the present registry is similar to that used in most recent randomized trials [1][2][3][4]17 and thus, includes cases without definite angiographic or postmortem documentation when a diagnosis of stent thrombosis was considered likely up to 30 days after the index procedure.…”

Section: Discussionmentioning

confidence: 99%

Safety of Coronary Sirolimus-Eluting Stents in Daily Clinical Practice

Urban¹,

Gershlick²,

Guagliumi³

et al. 2006

Circulation

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implantation of Ն1 SES at 279 medical centers from 41 countries. An independent endpoint review committee adjudicated all reported major adverse cardiovascular events, stent thromboses, and target-vessel revascularizations. Data were managed and analyzed by independent organizations. Predictors of adverse clinical events were identified by regression analysis. The mean age of the sample was 61.7Ϯ11.4 years; 77.7% were men, and 28.6% were diabetics. A total of 18 295 lesions were treated (20 503 SES) during the index procedure. The cumulative rates of major adverse cardiovascular events were 1.36% at 30 days, 3.38% at 6 months, and 5.80% at 1 year. The rates of acute, subacute, and late stent thrombosis were 0.13%, 0.56%, and 0.19% of patients, respectively, representing a 12-month actuarial incidence of 0.87%. Insulin-dependent diabetes, acute coronary syndrome at presentation, and advanced age were clinical predictors, whereas TIMI flow grade Ͻ3 after the index procedure, treatment of multiple lesions, a prominently calcified or totally occluded target lesion, and multivessel disease were the angiographic or procedural predictors of stent thrombosis at 12 months. Conclusions-This analysis of 1-year data collected by the e-Cypher registry suggests a high degree of safety of SES, with a rate of stent thrombosis similar to that observed in randomized trials.

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“…[12][13][14][15] Our stenting technique in ostium and/or shaft unprotected LMCA has been previously described. 16 At the start of the procedure, a bolus of unfractionated heparin (100 IU/kg) was administered to achieve an activated clotting time Ͼ250 seconds.…”

Section: Methodsmentioning

confidence: 99%

Favorable Long-Term Outcome After Drug-Eluting Stent Implantation in Nonbifurcation Lesions That Involve Unprotected Left Main Coronary Artery

et al. 2007

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Background-The presence of a lumen narrowing at the ostium and the body of an unprotected left main coronary artery but does not require bifurcation treatment is a class I indication of surgical revascularization. Methods and Results-A total of 147 consecutive patients who had a stenosis in the ostium and/or the midshaft of an unprotected left main coronary artery (treatment of the bifurcation not required) and were electively treated with percutaneous coronary intervention and sirolimus-eluting stents (nϭ107) or paclitaxel-eluting stents (nϭ40) in 5 centres were included in this registry. In 72 patients (almost 50%), intravascular ultrasound guidance was performed. Procedural success was achieved in 99% of the patients; in 1 patient with stenosis in the left main coronary artery ostium, a Ͼ30% residual stenosis persisted at the end of the procedure, and the patient was referred for coronary artery bypass graft surgery. During hospitalization, no patients experienced a Q-wave myocardial infarction or died. One patient died 19 days after the procedure because of pulmonary infection. At long-term clinical follow-up (886Ϯ308 days), 5 patients had died; 7 patients had target vessel revascularization (5 repeat percutaneous coronary interventions and 2 coronary artery bypass graft surgeries), and of these only 1 patient had a target lesion revascularization. Angiographic follow-up was performed in 106 patients (72%) with a late loss of Ϫ0.01 mm. Restenosis in the left main trunk occurred only in 1 patient (0.9%). Conclusions-Percutaneous coronary intervention with sirolimus-eluting stents or paclitaxel-eluting stents implantation in nonbifurcation left main coronary artery lesions appears safe with a long-term major adverse clinical event rate of 7.4% and a restenosis rate of 0.9%. (Circulation. 2007;116:158-162.)

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Intraprocedural Stent Thrombosis During Implantation of Sirolimus-Eluting Stents

Cited by 87 publications

References 22 publications

Percutaneous Treatment With Drug-Eluting Stent Implantation Versus Bypass Surgery for Unprotected Left Main Stenosis

Percutaneous Treatment With Drug-Eluting Stent Implantation Versus Bypass Surgery for Unprotected Left Main Stenosis

Safety of Coronary Sirolimus-Eluting Stents in Daily Clinical Practice

Favorable Long-Term Outcome After Drug-Eluting Stent Implantation in Nonbifurcation Lesions That Involve Unprotected Left Main Coronary Artery

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