Late Angiographic Stent Thrombosis (LAST) Events With Drug-Eluting Stents

Ong, Andrew T.L.; McFadden, Eugène; Regar, Evelyn; Jaegere, Peter P.T. de; Domburg, Ron T. van; Serruys, Patrick W.

doi:10.1016/j.jacc.2005.02.086

Cited by 590 publications

(362 citation statements)

References 15 publications

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“…[18][19][20] Premature discontinuation of antiplatelet therapy is strongly associated with stent thrombosis, 21,22 and some individuals are resistant to antiplatelet therapy. In the real world, more clinical trials and long-term follow-up is necessary to conclude the safety of DES, because some patients and more complex lesions are excluded from large clinical trials.…”

Section: Discussionmentioning

confidence: 99%

Inflammation and Delayed Endothelization With Overlapping Drug-Eluting Stents in a Porcine Model of In-Stent Restenosis

Lim

Jeong

Hong

et al. 2008

Circ J

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iffuse, long coronary lesions are associated with an increased rate of restenosis and poor outcome, despite the development of percutaneous coronary intervention (PCI) techniques. [1][2][3] In particular, the implantation of multiple, overlapping, bare metal stents (BMS) has a high restenosis rate. 4,5 Use of drug-eluting stents (DES) results in a significant and sustained suppression of neointimal proliferation, and has greatly attenuated the relationship between stent length and restenosis rate. As a result, a long DES is usually selected for a diffuse coronary lesion, but if a residual segment of the lesion is left uncovered, additional stenting with some overlap is considered to eliminate the risk of a residual stent gap.Thus in the case of a diffuse, long coronary lesion, overlapping DES are used for complete lesion coverage, but there has been concern whether the overlapping DES have the effect of increasing the local drug dose or whether they Circulation Journal Vol.72, March 2008 could result in dose-related side-effects, such as delayed arterial healing and promotion of inflammation, as compared with overlapping BMS. 6 Few histopathological studies have been done on the response to overlapping DES or BMS, and even less so for the overlapping of different DES, such as the sirolimus-eluting stent (SES) or pacletaxel-eluting stent (PES). Therefore, the present study assessed the histopathological response and the effect on neointimal hyperplasia of overlapping DES or BMS in a porcine model of coronary in-stent restenosis (ISR). Methods Animal Study ProtocolThe animal study was approved by the Ethical Committee of the Chonnam National University Hospital. Study animals were female swine weighing 25-35 kg. To decrease the incidence of acute thrombosis after stenting, premedication with aspirin 100 mg and clopidogrel 75 mg/day was given for 7 days before the procedure. On the day of stent implantation, pigs were anesthetized with ketamine (20 mg/kg intramuscularly) and xylazine (2 mg/kg intramuscularly) and maintained on 3 L/min of supplemental oxygen continuously through a mask. After subcutaneous 2% lidocaine was administered at the cut-down site the left carotid artery was surgically exposed, and a 7F sheath was inserted. Continuous hemodynamic and surface electrocardiographic monitoring was maintained throughout the procedure. After 10,000 units of heparin were administered intravenously as a bolus

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Section: Discussionmentioning

confidence: 99%

Inflammation and Delayed Endothelization With Overlapping Drug-Eluting Stents in a Porcine Model of In-Stent Restenosis

Lim

Jeong

Hong

et al. 2008

Circ J

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“…Coronary stents consisting of bioabsorbable metals are an emerging technology 3 which has the potential to address limitations in the current generation of permanent stents, 4 such as in-stent restenosis and late-stent thrombosis [1][2][3]. These devices have shown promise 5 in early clinical trials [4,5], however improvements in device performance are still required 6 prior to their adoption in preference to the current generation of permanent stents.…”

Section: Introductionmentioning

confidence: 99%

A physical corrosion model for bioabsorbable metal stents

2014

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“…[2][3][4] ST with DESs may be associated with significantly higher mortality rates that are related to myocardial infarctions. This rare, but serious complication has drawn the attention of interventional cardiologists.…”

Section: Discussionmentioning

confidence: 99%

Very Late Stent Thrombosis Related to Fracture of a Sirolimus-Eluting Stent

2007

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Although late stent thrombosis is a very rare complication after a drug-eluting stent implantation, this could induce significant sequelae. Several mechanisms for very late stent thrombosis have been suggested. We experienced a new possible mechanism of very late stent thrombosis after the implantation of a sirolimus-eluting stent. A sirolimus-eluting stent fracture might induce mechanical injury of the endothelium and then thrombotic occlusion at 24 months after the stent procedure. (Korean Circulation J 2007;37:385-387) KEY WORDS：Thrombosis；Stents；Sirolimus.

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Late Angiographic Stent Thrombosis (LAST) Events With Drug-Eluting Stents

Abstract: Angiographically proven late stent thrombosis occurs with an incidence of at least 0.35% (95% confidence limits 0.17% to 0.72%) in patients treated with DES. Importantly, it may also occur when patients are stable on antiplatelet monotherapy.

Cited by 590 publications

References 15 publications

Inflammation and Delayed Endothelization With Overlapping Drug-Eluting Stents in a Porcine Model of In-Stent Restenosis

Inflammation and Delayed Endothelization With Overlapping Drug-Eluting Stents in a Porcine Model of In-Stent Restenosis

A physical corrosion model for bioabsorbable metal stents

Very Late Stent Thrombosis Related to Fracture of a Sirolimus-Eluting Stent

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