Two‐year follow‐up intravascular ultrasound analysis after bare metal stent implantation in 120 lesions

The objective of this study was to examine long‐term changes after bare metal stent implantation in a relatively large number of patients. There are few reports of intravascular ultrasound (IVUS) studies performed on stented and nonstented (reference) segments beyond 6 months after bare metal stenting. Using IVUS, we evaluated serial changes in stented and reference segments between 6 and 24 months after stent implantation in 110 patients with 120 lesions. Serial IVUS images were acquired at five equidistant intrastent sites and at two different reference segment sites. Measurements were made of the external elastic membrane (EEM), stent, lumen, and intimal hyperplasia (IH = stent − lumen) area. For the whole patient group, between 6 and 24 months, the mean IH area in stented segments decreased from 2.6 ± 1.0 to 2.3 36± 0.9 mm2 (P < 0.001), and the mean lumen area increased from 6.2 ± 2.0 to 6.5 ± 1.9 mm2 (P < 0.001). The mean IH area decreased in 91 lesions (76%) and increased in 29 lesions (24%) between 6 and 24 months. There were no significant changes in EEM or lumen area in the reference segments. Late angiographic restenosis (diameter stenosis ≥ 50%) occurred in three lesions between 6 and 24 months. A late target lesion revascularization was performed for one lesion. In the period of time between 6 and 24 months after stenting, IH regression occurred in most (76%) stent lesions, resulting in late lumen increase. However, IH progression was observed in 24% of in‐stent lesions. No significant changes of EEM or lumen area occurred in the reference segments. © 2005 Wiley‐Liss, Inc.

[1]  Seung‐Jung Park,et al.  Late intravascular ultrasound findings of patients treated with brachytherapy for diffuse in-stent restenosis. , 2004, Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions.

[2]  G. Stone,et al.  A polymer-based, paclitaxel-eluting stent in patients with coronary artery disease. , 2004, The New England journal of medicine.

[3]  P. Serruys,et al.  Two-Year Angiographic and Intravascular Ultrasound Follow-Up After Implantation of Sirolimus-Eluting Stents in Human Coronary Arteries , 2003, Circulation.

[4]  Patrick W. Serruys,et al.  A randomized comparison of a sirolimus eluting stent with a standard stent for coronary revascularization , 2002 .

[5]  M. Nobuyoshi,et al.  Long-Term Clinical and Angiographic Follow-Up After Coronary Stent Placement in Native Coronary Arteries , 2002, Circulation.

[6]  P. Serruys,et al.  A randomized comparison of a sirolimus-eluting stent with a standard stent for coronary revascularization. , 2002, The New England journal of medicine.

[7]  Yoshio Kobayashi,et al.  Intimal hyperplasia regression from 6 to 12 months after stenting. , 2002, The American journal of cardiology.

[8]  G. Guagliumi,et al.  Long-term (> or =8 years) outcome after Palmaz-Schatz stent implantation. , 2001, The American journal of cardiology.

[9]  C. Tracy,et al.  American College of Cardiology Clinical Expert Consensus Document on Standards for Acquisition, Measurement and Reporting of Intravascular Ultrasound Studies (IVUS). A report of the American College of Cardiology Task Force on Clinical Expert Consensus Documents. , 2001, Journal of the American College of Cardiology.

[10]  R. Virmani,et al.  Histopathologic analysis of in‐stent neointimal regression in a porcine coronary model , 2000, Coronary artery disease.

[11]  P. Serruys,et al.  Long term outcome after coronary stent implantation: a 10 year single centre experience of 1000 patients , 1999, Heart.

[12]  M. Hori,et al.  Remodeling of in-stent neointima, which became thinner and transparent over 3 years: serial angiographic and angioscopic follow-up. , 1998, Circulation.

[13]  HaraldMudra,et al.  Serial Follow-up After Optimized Ultrasound-Guided Deployment of Palmaz-Schatz Stents , 1997 .

[14]  E. Regar,et al.  Serial follow-up after optimized ultrasound-guided deployment of Palmaz-Schatz stents. In-stent neointimal proliferation without significant reference segment response. , 1997, Circulation.

[15]  M. Leon,et al.  Patterns and mechanisms of in-stent restenosis. A serial intravascular ultrasound study. , 1996, Circulation.

[16]  H Yokoi,et al.  Three-year follow-up after implantation of metallic coronary-artery stents. , 1996, The New England journal of medicine.

[17]  J. Hermiller,et al.  Late coronary artery stenosis regression within the Gianturco-Roubin intracoronary stent. , 1996, The American journal of cardiology.

[18]  Y. Friedlander,et al.  High-dose fluvastatin and bezafibrate combination treatment for heterozygous familial hypercholesterolemia. , 1995, The American journal of cardiology.

[19]  I. Penn,et al.  Late angiographic follow-up after Palmaz-Schatz stent implantation , 1995 .