010 Plateau for occurrence of very late stent thrombosis beyond 3-years after implantation of the Sirolimus-eluting stent: long term follow-up of the EVASTENT patients

Aim : The aim of this study is to compare the 4 years safety and durability of Sirolimus-eluting stent (SES) and Paclitaxel-eluting stent (PES) deployment on the outcome of patients with very long coronary lesions (VLL). Methods : A prospective analysis of 656 patients 730 lesions (male 70.4%, mean age 66.9 yrs) with very long coronary lesion (≥40mm) (368 SES and 288 PES) in five high volume Asian centers after successful stenting in VLL was performed. Lesion locations of VLL were LAD 48.2% (SES 50.2%, PES 45.7%), LCX 18.5%, RCA 33.3%. Complete clinical follow-up to 4 years is being analyzed for all patients. Results : The baseline clinical characteristics between 2 groups were similar. At 4 years overall cardiac events of SES (16.3%) were lower than PES (24.0%) (p=0.03). See table for clinical results. Conclusion : The use of SES and PES in patients with very long coronary lesion was safe and feasible with low acute complication and low incidence of restenosis. SES showed lesser incidence of cardiac events (death, myocardial infarction, CABG and PCI) at 4 years clinical follow-up. SAT (sub acute stent thrombosis), LAST (late stent thrombosis: ~1year), VLAST (very late stent thrombosis: 1year~ 4years) MACE (death, myocardial infarction, CABG and PCI).

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Abstract 2566: Late and Very Late Stent Thrombosis following Elective Drug Eluting Stent Implantation in Unprotected Left Main Coronary Artery: a Multicentre Registry

Circulation ◽

10.1161/circ.116.suppl_16.ii_567-d ◽

2007 ◽

Vol 116 (suppl_16) ◽

Author(s):

Alaide Chieffo ◽

Young H Kim ◽

Emanuele Meliga ◽

Seung J Park ◽

Marco Valgimigli ◽

...

Keyword(s):

Coronary Artery ◽

Stent Thrombosis ◽

Left Main Coronary Artery ◽

Drug Eluting Stent ◽

Late Stent Thrombosis ◽

Left Main ◽

Very Late Stent Thrombosis ◽

Drug Eluting

The long-term safety of drug-eluting stent (DES) implantation in the treatment of unprotected left main coronary artery (LMCA) stenosis is still a matter of debate. Some concerns have been recently raised regarding the risk of late and very late stent thrombosis (ST). Methods: All consecutive patients (pts) who had sirolimus (SES, Cypher, Cordis, Johnson and Johnson Company, Warren, NJ) or paclitaxel-eluting stent (PES, Taxus, Boston Scientific, Natick, MA) electively implanted in de novo lesions on LMCA between March 2002 and June 2006 were included in this multicentre registry. Stent thromboses were defined according to Academic Research Consortium (ARC) definitions. Results Five-hundred and thirty-four consecutive patients were analyzed: 357 patients were treated with SES, 168 with PES and 9 with both of them. One-hundred and thirty-eight (25.8%) patients were diabetics, 171 (32.0%) unstable angina, mean age 62.4 ± 11.4 years, EF 54.1 ± 11.2 %. Distal location occurred in 417 (78.0%) of the patients. Fifty-seven (10.6%) patients had a peri-procedural myocardial infarction (defined as CK-MB elevation ≥3 ULN). At 1044 ± 361 day clinical follow-up, 32 (5.9%) patients died: 23 (4.3%) were adjudicated as cardiac according to ARC definition. One patient had an acute ST (with cardiogenic shock treated with CABG), 1 a sub-acute ST (occlusion of circumflex artery treated with PCI) and 1 a late definite ST (in the left anterior descending artery with MI at 3 months while on antiplatelet therapy). None of the patients had a very late definite ST. In the Table are reported probable and possibile ST. Conclusions Treatment of LMCA stenosis with DES appears safe at long-term clinical follow-up with a 0.6% incidence of definite and probable ST at a median follow-up of almost 3 years. Table.

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Long-term follow-up after coronary stenting with the sirolimus-eluting stent in clinical practice: results from the prospective multi-center German Cypher Stent Registry

Clinical Research in Cardiology ◽

10.1007/s00392-012-0448-y ◽

2012 ◽

Vol 101 (9) ◽

pp. 709-716 ◽

Cited By ~ 8

Author(s):

Ralf Zahn ◽

Franz-Josef Neumann ◽

Heinz-Joachim Büttner ◽

Gert Richardt ◽

Steffen Schneider ◽

...

Keyword(s):

Clinical Practice ◽

Coronary Stenting ◽

Long Term Follow Up ◽

Sirolimus Eluting Stent

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Very Late Stent Thrombosis in Late Stent Malapposition After Sirolimus-Eluting Stent Implantation

International Heart Journal ◽

10.1536/ihj.48.591 ◽

2007 ◽

Vol 48 (5) ◽

pp. 591-596 ◽

Cited By ~ 10

Author(s):

Feng Zhang ◽

Juying Qian ◽

Junbo Ge

Keyword(s):

Stent Thrombosis ◽

Stent Implantation ◽

Late Stent Thrombosis ◽

Very Late Stent Thrombosis ◽

Sirolimus Eluting Stent

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The Association Between S100A8/A9 and the Development of Very Late Stent Thrombosis in Patients With Acute Myocardial Infarction

Clinical and Applied Thrombosis/Hemostasis ◽

10.1177/1076029620943295 ◽

2020 ◽

Vol 26 ◽

pp. 107602962094329

Author(s):

Xiang Wang ◽

Meng Guan ◽

Xiuhang Zhang ◽

Taiyuan Ma ◽

Muli Wu ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Stent Thrombosis ◽

High Sensitivity ◽

Coronary Intervention ◽

Serum Levels ◽

Late Stent Thrombosis ◽

Very Late Stent Thrombosis ◽

Hs Crp

Very late stent thrombosis (VLST) is a rare but serious complication following percutaneous coronary intervention (PCI). S100A8/A9 plays an important role in thrombosis through modulating the inflammatory response. This observational study aimed to reveal the association between S100A8/A9 and VLST. Continuous blood samples were collected from patients at both the time of index PCI for acute myocardial infarction (AMI) and the time of PCI for VLST (VLST group) or follow-up coronary angiography (AMI group). In all, 56 patients were selected in each group from a cohort of 8476 patients and other 112 individuals who underwent health checkups (normal control [NC] group) were selected as controls. Serum levels of S100A8/A9 and high sensitivity C-reactive protein (hs-CRP) were tested and compared. The mean level of S100A8/A9 was 3754.4 ± 1688.9 ng/mL during index PCI and increased to 5517.8 ± 2650.9 ng/mL at the time of VLST; in the AMI group, S100A8/A9 level was 2434.9 ± 1243.4 ng/mL during index PCI and decreased to 1568.2 ± 772.1 ng/mL during follow-up, similar to that detected in the NC group (1618.2 ± 641.4 ng/mL). Of note, S100A8/A9 levels showed significant increases during VLST when compared to its own levels during index PCI, which was different from the changes of hs-CRP. Higher serum levels of S100A8/A9 are associated with the development of VLST.

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Orsiro: ultrathin bioabsorbable polymer sirolimus-eluting stent

Future Cardiology ◽

10.2217/fca-2019-0001 ◽

2019 ◽

Vol 15 (4) ◽

pp. 295-300 ◽

Cited By ~ 2

Author(s):

Ofer Kobo ◽

Ariel Roguin

Keyword(s):

Clinical Performance ◽

Drug Eluting Stents ◽

Bioabsorbable Polymer ◽

Coronary Syndrome ◽

Long Term Follow Up ◽

Potential Benefits ◽

Drug Eluting ◽

Sirolimus Eluting Stent

Recent stent developments aimed to reduce and eliminate the long-term inflammatory response include thinner struts, modifications to stent design and the development of bioresorbable polymers (BP). We aimed to summarize the main findings and to discuss the established and the potential benefits of the Orsiro BP sirolimus-eluting stents in everyday clinical use. We have reviewed the available evidence on the clinical performance of the Orsiro BP drug-eluting stents. Orsiro BP sirolimus-eluting stents is clinically proven and showed noninferiority against major drug-eluting stents and provides high safety and efficacy profile at long-term follow-up. Furthermore, it may be the preferred treatment option in specific subgroups as acute coronary syndrome, as shown in the BIOFLOW V trial.

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