Abstract 6001: Two Years Clinical Registry Follow Up of Endothelial Progenitor Cell Capture Stent versus Sirolimus-Eluting Bioabsorbable Polymer-Coated Stent versus Bare Metal Stents in Patients Undergoing Primary Percutaneous Coronary Intervention for ST Elevation Myocardial Infarction

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Eric Chong ◽  
Liang Shen ◽  
Chao Y Soon ◽  
Hean Y Ong ◽  
Kian K Poh ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Stent Thrombosis ◽  
Progenitor Cell ◽  
Coronary Intervention ◽  
Bare Metal ◽  
Late Stent Thrombosis ◽  
Bioabsorbable Polymer ◽  
Percutaneous Coronary

Background: Endothelial progenitor cell (EPC) capture stent (Genous ™ , OrbusNeich), is designed to promote rapid endothelization and healing and is potentially useful in patients undergoing primary percutaneous coronary intervention (PPCI) for acute ST-segment elevation myocardial infarction (STEMI). We compare its clinical efficacy and safety with a sirolimus-eluting (SES) bioabsorbable polymer-coated stent (Cura ™ , OrbusNeich) and a bare metal stent (BMS) (Liberte ™ , Boston scientific) in patients presenting with STEMI. Methods: All patients presented to our center with STEMI and received PPCI with either EPC, SES or BMS stents between Jan 2004 and June 2006 were enrolled in the cohort study. The study endpoints were major adverse cardiac events (MACE) defined as composite end point of death, myocardial infarction (MI) and target vessel revascularization (TVR) at 2 years as well as acute, subacute and late stent thrombosis. Results: A total of 366 patients (EPC=95, SES=53, BMS 218) were enrolled. Baseline demographics in terms of age, gender, diabetes mellitus, baseline renal impairment, pre-discharge left ventricular ejection fraction, cardiogenic shock were comparable among the 3 groups. Procedural success rate was high at a mean of 99.5%. Post-procedural TIMI 3 flow was achieved in EPC 91.6%, SES 96.2% and BMS 88.5%. The MACE and stent thrombosis results at 2 years are shown in the table . Conclusion: The MACE rates among patients who underwent PPCI were similar in all 3 stent groups at 2 years follow-up. There was no difference in TVR rate and stent thrombosis remains a low event occurrence. None of the patients in the EPC stent group developed late stent thrombosis at 2 years follow up.

scholarly journals Stent Thrombosis after Rescue Percutaneous Coronary Intervention in Acute ST-Segment Elevation Myocardial Infarction

2015 ◽  
Vol 9 (1) ◽  
pp. 127-132 ◽  
Author(s):  
Khalid Bin Thani ◽  
Fajer Al-Moosa ◽  
Eman Murad ◽  
Aisha Al-Moosa ◽  
Mohamed E. Alalawi ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Thrombolytic Therapy ◽  
Stent Thrombosis ◽  
Coronary Intervention ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Percutaneous Coronary

Main Problem:To determine the incidence of coronary stent thrombosis (ST) in patients with acute ST segment elevation myocardial infarction (STEMI) after rescue percutaneous coronary intervention (PCI). Methods:An observational study looking at the incidence of ST in a middle-eastern population. A total of 510 consecutive patients presented with ST-segment elevation myocardial infarction (STEMI) were enrolled and underwent thrombolytic therapy with a total follow-up period of 2 years. Study outcomes were ST, death, re-infarction or acute coronary syndrome requiring coronary angiography and PCI. Results:A total of 510 patients enrolled, all diagnosed with STEMI and underwent thrombolytic therapy. Only 100 subjects underwent rescue PCI with intra-coronary stenting, including 54 patients with drug-eluting stent (DES) and 46 patients with bare metal stent (BMS). During the study period and follow-up, the overall rate of ST was 13.7%, definite ST occurred in 6 patients (5.5%), probable ST in 8 patients (7.3%), and possible ST in one patient (0.9%), including 0.9% acute ST, 0.9% sub-acute ST, 2.8% late ST and 8.3% very late ST. Patients with ST were likely to have prior PCI (p=0.001), prior coronary artery bypass grafting (CABG) (p=0.002) and history of heart failure (p=0.04). Conclusion:ST is infrequent event with major consequences in patients presenting with STEMI in the first 2 years after stent implantation.

scholarly journals Very late stent thrombosis of bare-metal coronary stent nine years after primary percutaneous coronary intervention

2016 ◽  
Vol 73 (8) ◽  
pp. 774-778 ◽  
Author(s):  
Predrag Djuric ◽  
Slobodan Obradovic ◽  
Zoran Stajic ◽  
Marijan Spasic ◽  
Radomir Matunovic ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Stent Thrombosis ◽  
Antithrombotic Therapy ◽  
Coronary Intervention ◽  
Stent Fracture ◽  
Bare Metal ◽  
Thrombus Aspiration ◽  
Late Stent Thrombosis ◽  
Very Late Stent Thrombosis ◽  
Percutaneous Coronary

Introduction. Stent thrombosis (ST) in clinical practice can be classified according to time of onset as early (0?30 days after stent implantation), which is further divided into acute (< 24 hours) and subacute (1?30 days), late (> 30 days) and very late (> 12 months). Myocardial reinfaction due to very late ST in a patient receiving antithrombotic therapy is very rare, and potentially fatal. The procedure alone and related mechanical factors seem to be associated with acute/subacute ST. On the other hand, in-stent neoathero-sclerosis, inflammation, premature cessation of antiplatelet therapy, as well as stent fracture, stent malapposition, un-covered stent struts may play role in late/very late ST. Some findings implicate that the etiology of very late ST of bare-metal stent (BMS) is quite different from those following drug-eluting stent (DES) implantation. Case report. We presented a 56-year old male with acute inferoposterior ST segment elevation myocardial infarction (STEMI) related to very late stent thrombosis, 9 years after BMS implantation, despite antithrombotic therapy. Thrombus aspiration was successfully performed followed by percutaneous coronary intervention (PCI) with implantation of DES into the pre-viously implanted two stents to solve the in-stent restenosis. Conclusion. Very late stent thrombosis, although fortu-nately very rare, not completely understood, might cause myocardial reinfaction, but could be successfully treated with thrombus aspiration followed by primary PCI. Very late ST in the presented patient might be connected with neointimal plaque rupture, followed by thrombotic events.

scholarly journals Everolimus-Eluting versus Paclitaxel-Eluting Stents in Percutaneous Coronary Intervention: Meta-Analysis of Randomized Trials

Thrombosis ◽  
2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Ashraf Alazzoni ◽  
Ayman Al-Saleh ◽  
Sanjit S. Jolly
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Stent Thrombosis ◽  
Randomized Trials ◽  
Meta Analysis ◽  
Coronary Intervention ◽  
Target Vessel ◽  
Late Stent Thrombosis ◽  
Very Late Stent Thrombosis ◽  
Target Vessel Revascularization ◽  
Percutaneous Coronary

Background. Individual randomized trials have suggested that everolimus-eluting stents may have improved clinical outcomes compared to paclitaxel-eluting stents, but individual trials are underpowered to examine outcomes such as mortality and very late stent thrombosis. Methods. Medline, Cochrane, and conference proceedings were searched for randomized trials comparing everolimus versus paclitaxel-eluting stents for percutaneous coronary intervention. Results. 6792 patients were included from 4 randomized controlled trials. Stent thrombosis was reduced with everolimus stents versus paclitaxel stents (0.7% versus 2.3%; OR: 0.32; CI: 0.20–0.51; P<0.00001). The reductions in stent thrombosis were observed in (i) early stent thrombosis (within 30 days) (0.2% versus 0.9%; OR: 0.24; P=0.0005), (ii) late (day 31–365) (0.2% versus 0.6%; OR: 0.32; P=0.01), and (iii) very late stent thrombosis (>365 days) (0.2% versus 0.8%; OR: 0.34; P=0.009). The rates of cardiovascular mortality were 1.2% in everolimus group and 1.6% in paclitaxel group (OR: 0.85; P=0.43). Patients receiving everolimus-eluting stents had significantly lower myocardial infarction events and target vessel revascularization as compared to paclitaxel-eluting stents. Interpretation. Everolimus compared to paclitaxel-eluting stents reduced the incidence of early, late, and very late stent thrombosis as well as target vessel revascularization.

Sign in / Sign up

Export Citation Format

Share Document