Predictors and Long-Term Clinical Outcome of Longitudinal Stent Deformation: Insights From Pooled Analysis of Korean Multicenter Drug-Eluting Stent Cohort

Tae Min Rhee; Kyung Woo Park; Joo Myung Lee; Michael S. Lee; Ki Hyun Jeon; Hyun Jae Kang; Bon Kwon Koo; Jay Young Rhew; Kwang Soo Cha; Jang Ho Bae; Kyoo Rok Han; Si Hoon Park; Woo Jung Park; Seung Woon Rha; Seok Kyu Oh; Hyuck Moon Kwon; Ki Bae Seung; Taehoon Ahn; Sang Hyun Kim; Hyo Soo Kim

doi:10.1161/CIRCINTERVENTIONS.117.005518

Predictors and Long-Term Clinical Outcome of Longitudinal Stent Deformation: Insights From Pooled Analysis of Korean Multicenter Drug-Eluting Stent Cohort

Tae Min Rhee, Kyung Woo Park, Joo Myung Lee, Michael S. Lee, Ki Hyun Jeon, Hyun Jae Kang, Bon Kwon Koo, Jay Young Rhew, Kwang Soo Cha, Jang Ho Bae, Kyoo Rok Han, Si Hoon Park, Woo Jung Park, Seung Woon Rha, Seok Kyu Oh, Hyuck Moon Kwon, Ki Bae Seung, Taehoon Ahn, Sang Hyun Kim, Hyo Soo Kim

Research output: Contribution to journal › Article › peer-review

18 Citations (Scopus)

Abstract

BACKGROUND: There are limited data on the frequency of and factors associated with quantitative coronary angiography (QCA)-defined longitudinal stent deformation (LSD) in various contemporary drug-eluting stents platforms. This study sought to evaluate the predictors of LSD and its long-term clinical implication.

METHODS AND RESULTS: A patient-level pooled analysis was performed with 7350 lesions in 5871 patients treated with platinum-chromium-based everolimus-eluting stent (Promus Element), cobalt-chromium-based everolimus-eluting stent (Promus/Xience V), or cobalt-chromium-based zotarolimus-eluting stent (Endeavor Resolute). QCA was performed to analyze differences of stent length between immediate post-deployment and final post-procedure. Independent factors associated with LSD were identified. Clinical outcomes at 3 years were compared between those with and without QCA-based LSD. The frequency of QCA-based LSD was 1.12% (82 cases). Nine of these cases were angiographically overt. Left main or ostial lesion, bifurcation treatment with provisional side branch stenting or ballooning, additional downstream intervention of a distal lesion, intravascular ultrasound use, and adjunctive post-dilatation were independently associated with QCA-based LSD. The type of stent was not associated with QCA-based LSD. Rates of target lesion failure were nominally higher in lesions with QCA-based LSD than in those without (8.97% versus 5.88%; hazard ratio, 1.415; 95% confidence interval, 0.631-3.175; P=0.399).

CONCLUSIONS: LSD is uncommon with contemporary drug-eluting stents, regardless of the type of stent platform. LSD is mainly associated with procedural factors, especially with additional downstream procedures which require the passage of devices through the stent. Careful manipulation of poststent imaging or procedural devices is required to prevent LSD. More data are needed to clarify the impact of LSD on clinical events.

Original language	English
Journal	Circulation. Cardiovascular interventions
Volume	10
Issue number	11
DOIs	https://doi.org/10.1161/CIRCINTERVENTIONS.117.005518
Publication status	Published - 2017 Nov 1
Externally published	Yes

Bibliographical note

Publisher Copyright:
© 2017 American Heart Association, Inc.

Keywords

coronary angiography
drug-eluting stents
percutaneous coronary intervention
risk factors
stents

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine

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10.1161/CIRCINTERVENTIONS.117.005518

Cite this

Rhee, T. M., Park, K. W., Lee, J. M., Lee, M. S., Jeon, K. H., Kang, H. J., Koo, B. K., Rhew, J. Y., Cha, K. S., Bae, J. H., Han, K. R., Park, S. H., Park, W. J., Rha, S. W., Oh, S. K., Kwon, H. M., Seung, K. B., Ahn, T., Kim, S. H., & Kim, H. S. (2017). Predictors and Long-Term Clinical Outcome of Longitudinal Stent Deformation: Insights From Pooled Analysis of Korean Multicenter Drug-Eluting Stent Cohort. Circulation. Cardiovascular interventions, 10(11). https://doi.org/10.1161/CIRCINTERVENTIONS.117.005518

Rhee, TM, Park, KW, Lee, JM, Lee, MS, Jeon, KH, Kang, HJ, Koo, BK, Rhew, JY, Cha, KS, Bae, JH, Han, KR, Park, SH, Park, WJ, Rha, SW, Oh, SK, Kwon, HM, Seung, KB, Ahn, T, Kim, SH & Kim, HS 2017, 'Predictors and Long-Term Clinical Outcome of Longitudinal Stent Deformation: Insights From Pooled Analysis of Korean Multicenter Drug-Eluting Stent Cohort', Circulation. Cardiovascular interventions, vol. 10, no. 11. https://doi.org/10.1161/CIRCINTERVENTIONS.117.005518

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title = "Predictors and Long-Term Clinical Outcome of Longitudinal Stent Deformation: Insights From Pooled Analysis of Korean Multicenter Drug-Eluting Stent Cohort",

abstract = "BACKGROUND: There are limited data on the frequency of and factors associated with quantitative coronary angiography (QCA)-defined longitudinal stent deformation (LSD) in various contemporary drug-eluting stents platforms. This study sought to evaluate the predictors of LSD and its long-term clinical implication.METHODS AND RESULTS: A patient-level pooled analysis was performed with 7350 lesions in 5871 patients treated with platinum-chromium-based everolimus-eluting stent (Promus Element), cobalt-chromium-based everolimus-eluting stent (Promus/Xience V), or cobalt-chromium-based zotarolimus-eluting stent (Endeavor Resolute). QCA was performed to analyze differences of stent length between immediate post-deployment and final post-procedure. Independent factors associated with LSD were identified. Clinical outcomes at 3 years were compared between those with and without QCA-based LSD. The frequency of QCA-based LSD was 1.12% (82 cases). Nine of these cases were angiographically overt. Left main or ostial lesion, bifurcation treatment with provisional side branch stenting or ballooning, additional downstream intervention of a distal lesion, intravascular ultrasound use, and adjunctive post-dilatation were independently associated with QCA-based LSD. The type of stent was not associated with QCA-based LSD. Rates of target lesion failure were nominally higher in lesions with QCA-based LSD than in those without (8.97% versus 5.88%; hazard ratio, 1.415; 95% confidence interval, 0.631-3.175; P=0.399).CONCLUSIONS: LSD is uncommon with contemporary drug-eluting stents, regardless of the type of stent platform. LSD is mainly associated with procedural factors, especially with additional downstream procedures which require the passage of devices through the stent. Careful manipulation of poststent imaging or procedural devices is required to prevent LSD. More data are needed to clarify the impact of LSD on clinical events.",

keywords = "coronary angiography, drug-eluting stents, percutaneous coronary intervention, risk factors, stents",

author = "Rhee, {Tae Min} and Park, {Kyung Woo} and Lee, {Joo Myung} and Lee, {Michael S.} and Jeon, {Ki Hyun} and Kang, {Hyun Jae} and Koo, {Bon Kwon} and Rhew, {Jay Young} and Cha, {Kwang Soo} and Bae, {Jang Ho} and Han, {Kyoo Rok} and Park, {Si Hoon} and Park, {Woo Jung} and Rha, {Seung Woon} and Oh, {Seok Kyu} and Kwon, {Hyuck Moon} and Seung, {Ki Bae} and Taehoon Ahn and Kim, {Sang Hyun} and Kim, {Hyo Soo}",

note = "Publisher Copyright: {\textcopyright} 2017 American Heart Association, Inc.",

year = "2017",

month = nov,

day = "1",

doi = "10.1161/CIRCINTERVENTIONS.117.005518",

language = "English",

volume = "10",

journal = "Circulation. Cardiovascular interventions",

issn = "1941-7640",

publisher = "Lippincott Williams and Wilkins Ltd.",

number = "11",

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TY - JOUR

T1 - Predictors and Long-Term Clinical Outcome of Longitudinal Stent Deformation

T2 - Insights From Pooled Analysis of Korean Multicenter Drug-Eluting Stent Cohort

AU - Rhee, Tae Min

AU - Park, Kyung Woo

AU - Lee, Joo Myung

AU - Lee, Michael S.

AU - Jeon, Ki Hyun

AU - Kang, Hyun Jae

AU - Koo, Bon Kwon

AU - Rhew, Jay Young

AU - Cha, Kwang Soo

AU - Bae, Jang Ho

AU - Han, Kyoo Rok

AU - Park, Si Hoon

AU - Park, Woo Jung

AU - Rha, Seung Woon

AU - Oh, Seok Kyu

AU - Kwon, Hyuck Moon

AU - Seung, Ki Bae

AU - Ahn, Taehoon

AU - Kim, Sang Hyun

AU - Kim, Hyo Soo

PY - 2017/11/1

Y1 - 2017/11/1

N2 - BACKGROUND: There are limited data on the frequency of and factors associated with quantitative coronary angiography (QCA)-defined longitudinal stent deformation (LSD) in various contemporary drug-eluting stents platforms. This study sought to evaluate the predictors of LSD and its long-term clinical implication.METHODS AND RESULTS: A patient-level pooled analysis was performed with 7350 lesions in 5871 patients treated with platinum-chromium-based everolimus-eluting stent (Promus Element), cobalt-chromium-based everolimus-eluting stent (Promus/Xience V), or cobalt-chromium-based zotarolimus-eluting stent (Endeavor Resolute). QCA was performed to analyze differences of stent length between immediate post-deployment and final post-procedure. Independent factors associated with LSD were identified. Clinical outcomes at 3 years were compared between those with and without QCA-based LSD. The frequency of QCA-based LSD was 1.12% (82 cases). Nine of these cases were angiographically overt. Left main or ostial lesion, bifurcation treatment with provisional side branch stenting or ballooning, additional downstream intervention of a distal lesion, intravascular ultrasound use, and adjunctive post-dilatation were independently associated with QCA-based LSD. The type of stent was not associated with QCA-based LSD. Rates of target lesion failure were nominally higher in lesions with QCA-based LSD than in those without (8.97% versus 5.88%; hazard ratio, 1.415; 95% confidence interval, 0.631-3.175; P=0.399).CONCLUSIONS: LSD is uncommon with contemporary drug-eluting stents, regardless of the type of stent platform. LSD is mainly associated with procedural factors, especially with additional downstream procedures which require the passage of devices through the stent. Careful manipulation of poststent imaging or procedural devices is required to prevent LSD. More data are needed to clarify the impact of LSD on clinical events.

AB - BACKGROUND: There are limited data on the frequency of and factors associated with quantitative coronary angiography (QCA)-defined longitudinal stent deformation (LSD) in various contemporary drug-eluting stents platforms. This study sought to evaluate the predictors of LSD and its long-term clinical implication.METHODS AND RESULTS: A patient-level pooled analysis was performed with 7350 lesions in 5871 patients treated with platinum-chromium-based everolimus-eluting stent (Promus Element), cobalt-chromium-based everolimus-eluting stent (Promus/Xience V), or cobalt-chromium-based zotarolimus-eluting stent (Endeavor Resolute). QCA was performed to analyze differences of stent length between immediate post-deployment and final post-procedure. Independent factors associated with LSD were identified. Clinical outcomes at 3 years were compared between those with and without QCA-based LSD. The frequency of QCA-based LSD was 1.12% (82 cases). Nine of these cases were angiographically overt. Left main or ostial lesion, bifurcation treatment with provisional side branch stenting or ballooning, additional downstream intervention of a distal lesion, intravascular ultrasound use, and adjunctive post-dilatation were independently associated with QCA-based LSD. The type of stent was not associated with QCA-based LSD. Rates of target lesion failure were nominally higher in lesions with QCA-based LSD than in those without (8.97% versus 5.88%; hazard ratio, 1.415; 95% confidence interval, 0.631-3.175; P=0.399).CONCLUSIONS: LSD is uncommon with contemporary drug-eluting stents, regardless of the type of stent platform. LSD is mainly associated with procedural factors, especially with additional downstream procedures which require the passage of devices through the stent. Careful manipulation of poststent imaging or procedural devices is required to prevent LSD. More data are needed to clarify the impact of LSD on clinical events.

KW - coronary angiography

KW - drug-eluting stents

KW - percutaneous coronary intervention

KW - risk factors

KW - stents

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DO - 10.1161/CIRCINTERVENTIONS.117.005518

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AN - SCOPUS:85049024548

SN - 1941-7640

VL - 10

JO - Circulation. Cardiovascular interventions

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Predictors and Long-Term Clinical Outcome of Longitudinal Stent Deformation: Insights From Pooled Analysis of Korean Multicenter Drug-Eluting Stent Cohort

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

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