Impact of Post-Intervention Minimal Stent Area on 9-Month Follow-Up Patency of Paclitaxel-Eluting Stents An Integrated Intravascular Ultrasound Analysis From the TAXUS IV, V, and VI and TAXUS ATLAS Workhorse, Long Lesion, and Direct Stent Trials

被引：155

作者：

Doi, Hiroshi ^{[1
,2
]}

Maehara, Akiko ^{[1
,2
]}

Mintz, Gary S. ^{[1
,2
]}

Yu, Alan ^{[3
]}

Wang, Hong ^{[3
]}

Mandinov, Lazar ^{[3
]}

Popma, Jeffrey J. ^{[4
]}

Ellis, Stephen G. ^{[5
]}

Grube, Eberhard ^{[6
]}

Dawkins, Keith D. ^{[3
]}

Weissman, Neil J. ^{[7
]}

Turco, Mark A. ^{[8
]}

Ormiston, John A. ^{[9
]}

Stone, Gregg W. ^{[1
,2
]}

机构：

[1] Cardiovasc Res Fdn, New York, NY 10022 USA

[2] Columbia Univ, Med Ctr, New York, NY USA

[3] Boston Sci Corp, Natick, MA USA

[4] St Elizabeth Hosp, Boston, MA USA

[5] Cleveland Clin, Cleveland, OH 44106 USA

[6] Heart Ctr Siegburg, Siegburg, Germany

[7] Washington Hosp Ctr, Washington, DC 20010 USA

[8] Washington Adventist Hosp, Takoma Pk, MD USA

[9] Auckland City Hosp, Auckland, New Zealand

来源：

JACC-CARDIOVASCULAR INTERVENTIONS | 2009年 / 2卷 / 12期

关键词：

intravascular ultrasound; in-stent restenosis; paclitaxel-eluting stent; stent expansion; CORONARY-ARTERY-DISEASE; SIROLIMUS; IMPLANTATION; RESTENOSIS; COMPLEX;

D O I：

10.1016/j.jcin.2009.10.005

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objectives We investigated the predictive value of the intravascular ultrasound (IVUS) measured post-intervention minimum stent area (MSA) on 9-month follow-up paclitaxel-eluting stent (PES) patency compared with bare-metal stents (BMS). Background Stent underexpansion is a strong predictor for restenosis after sirolimus-eluting stent implantation, but the implication of underexpansion in PES is still unknown. Methods From the combined TAXUS IV, V, and VI and TAXUS ATLAS Workhorse, Long Lesion, and Direct Stent trials, 1,580 patients (PIES 1,098, BMS 482) in IVUS substudies were analyzed. The MSA that best predicted angiographic in-stent restenosis (ISR) (% diameter stenosis >= 50%) was determined. Results The post-intervention IVUS MSA was similar in PES and BMS (6.6 +/- 2.5 mm(2) vs. 6.7 +/- 2.3 mm(2), p = 0.92). At 9-month follow-up, ISR was lower in the PIES group versus the BMS group (10% vs. 31%, p < 0.0001). Using multivariable logistic regression analysis, post-intervention IVUS MSA was the independent predictor of subsequent ISR in both the PIES and BMS groups (p = 0.0002 for PIES and p = 0.0002 for BMS). The ability of the post-intervention IVUS MSA to predict ISR was further assessed using receiver operating characteristic analysis. The post-intervention IVUS MSA was found to be a faithful discriminator between patients with and without ISR in both PES (c = 0.6382) and BMS (c = 0.6373). Finally, the optimal thresholds of post-intervention IVUS MSA that best predicted stent patency at 9 months were 5.7 mm(2) for PES and 6.4 mm(2) for BMS. Conclusions Post-intervention MSA measured by IVUS can predict 9-month follow-up stent patency after both PES and BMS implantation. (Randomized Trial Evaluating Slow-Release Formulation TAXUS Paclitaxel-Eluting Coronary Stents to Treat De Novo Coronary Lesions; NCT00301522) (Direct Stenting of TAXUS Liberte-SR Stent for the Treatment of Patients With de Novo Coronary Artery Lesions; NCT00371423) (A Study of the TAXUS Liberte Stent for the Treatment of Long De Novo Coronary Artery Lesions; NCT00371475) (A Study of the TAXUS Liberte Stent for the Treatment of de Novo Coronary Artery Lesions in Small Vessels; NCT00371748) (J Am Coll Cardiol Intv 2009;2:1269-75) (C) 2009 by the American College of Cardiology Foundation

引用

页码：1269 / 1275

页数：7

共 15 条

[1] The contribution of "mechanical" problems to in-stent restenosis: An intravascular ultrasonographic analysis of 1090 consecutive in-stent restenosis lesions [J].

Castagna, MT ;

Mintz, GS ;

Leiboff, BO ;

Ahmed, JM ;

Mehran, R ;

Satler, LF ;

Kent, KM ;

Pichard, AD ;

Weissman, NJ .

AMERICAN HEART JOURNAL, 2001, 142 (06) :970-974

[2] Head-to-head comparison between sirolimus-eluting and paclitaxel-eluting stents in patients with complex coronary artery disease:: An intravascular ultrasound study [J].

Cervinka, Pavel ;

Costa, Marco A. ;

Angiolillo, Dominick J. ;

Spacek, Radim ;

Bystron, Marian ;

Kvasnak, Martin ;

Veselka, Josef ;

Nanda, Hitesh ;

Futamatsu, Hideki ;

Futamatsu, Kino .

CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, 2006, 67 (06) :846-851

[3] Intravascular ultrasound assessment of drug-eluting stent expansion [J].

Costa, Jose de Ribamar, Jr. ;

Mintz, Gary S. ;

Carlier, Stephane G. ;

Fujii, Kenichi ;

Sano, Koichi ;

Kimura, Masashi ;

Tanaka, Kaoru ;

Costa, Ricardo A. ;

Lui, Joanna ;

Na, Yingbo ;

Castellanos, Celia ;

Biro, Sinan ;

Moussa, Issam ;

Stone, Gregg W. ;

Moses, Jeffrey W. ;

Leon, Martin B. .

AMERICAN HEART JOURNAL, 2007, 153 (02) :297-303

[4] Clinical efficacy of polymer-based paclitaxel-eluting stents in the treatment of complex, long coronary artery lesions from a multicenter, randomized trial - Support for the use of drug-eluting Stents in contemporary clinical practice [J].

Dawkins, KD ;

Grube, E ;

Guagliumi, G ;

Banning, AP ;

Zmudka, K ;

Colombo, A ;

Thuesen, L ;

Hauptman, K ;

Marco, J ;

Wijns, W ;

Popma, JJ ;

Koglin, J ;

Russell, ME .

CIRCULATION, 2005, 112 (21) :3306-3313

[5] Intravascular ultrasound predictors of angiographic restenosis after sirolimus-eluting stent implantation [J].

Hong, Myeong-Ki ;

Mintz, Gary S. ;

Lee, Cheol Whan ;

Park, Duk-Woo ;

Choi, Bong-Ryong ;

Park, Kyoung-Ha ;

Kim, Young-Hak ;

Cheong, Sang-Sig ;

Song, Jae-Kwan ;

Kim, Jae-Joong ;

Park, Seong-Wook ;

Park, Seung-Jung .

EUROPEAN HEART JOURNAL, 2006, 27 (11) :1305-1310

[6] An optimal diagnostic threshold for minimal stent area to predict target lesion revascularization following stent implantation in native coronary lesions [J].

Morino, Y ;

Honda, Y ;

Okura, H ;

Oshima, A ;

Hayase, M ;

Bonneau, HN ;

Kuntz, RE ;

Yock, PG ;

Fitzgerald, PJ .

AMERICAN JOURNAL OF CARDIOLOGY, 2001, 88 (03) :301-+

[7] Sirolimus-eluting stents versus standard stents in patients with stenosis in a native coronary artery [J].

Moses, JW ;

Leon, MB ;

Popma, JJ ;

Fitzgerald, PJ ;

Holmes, DR ;

O'Shaughnessy, C ;

Caputo, RP ;

Kereiakes, DJ ;

Williams, DO ;

Teirstein, PS ;

Jaeger, JL ;

Kuntz, RE .

NEW ENGLAND JOURNAL OF MEDICINE, 2003, 349 (14) :1315-1323

[8] Restenosis and stent fracture following sirolimus-eluting stent (SES) implantation - A serial quantitative coronary angiography (QCA) and intravascular ultrasound (IVUS) study [J].

Okumura, Masanori ;

Ozaki, Yukio ;

Ishii, Junichi ;

Kan, Shino ;

Naruse, Hiroyuki ;

Matsui, Shigeru ;

Ishikawa, Makoto ;

Hattori, Kousuke ;

Gochi, Tomoko ;

Nakano, Tadashi ;

Yamada, Akira ;

Kato, Shigeru ;

Motoyama, Sadako ;

Sarai, Masayoshi ;

Takagi, Yasushi ;

Ismail, Tevfik F. ;

Nomura, Masanori ;

Hishida, Hitoshi .

CIRCULATION JOURNAL, 2007, 71 (11) :1669-1677

[9] Direct Stenting With the TAXUS Liberte Drug-Eluting Stent Results From the TAXUS ATLAS DIRECT STENT Study [J].

Ormiston, John A. ;

Mahmud, Ehtisham ;

Turco, Mark A. ;

Popma, Jeffrey J. ;

Weissman, Neil ;

Cannon, Louis A. ;

Mann, Tift ;

Lucca, Michael J. ;

Lim, Soo-Teik ;

Hall, Jack J. ;

McClean, Dougal ;

Dobies, David ;

Mandinov, Lazar ;

Baim, Donald S. .

JACC-CARDIOVASCULAR INTERVENTIONS, 2008, 1 (02) :150-160

[10] Randomized comparison of sirolimus and paclitaxel drug-eluting stents for long lesions in the left anterior descending artery - An intravascular ultrasound study [J].

Petronio, Anna Sonia ;

De Carlo, Marco ;

Branchitta, Giulia ;

Papini, Barbara ;

Ciabatti, Nicola ;

Gistri, Roberto ;

Cortese, Bernardo ;

Gherarducci, Gherardo ;

Barsotti, Antonio .

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2007, 49 (05) :539-546

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