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Late-acquired incomplete stent apposition: morphologic characterization

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Author(s)
Seung-Ho HurJunya AkoYasuhiro HondaKrishnankutty SudhirPeter J. Fitzgerald
Publication Year
2009
Abstract
Incomplete stent apposition (ISA) is a lack of contact between stents and the underlying vessel wall, best described by intravascular ultrasound (IVUS). Late acquired incomplete apposition, defined as complete stent apposition at the time of procedure but ISA at follow-up, is an unusual IVUS finding reported in intracoronary brachytherapy, bare-metal stent (BMS), and drug-eluting stent (DES) implantation. Late-acquired ISA is observed relatively more frequently with DES implantation compared with BMS implantation. Possible mechanisms of this phenomenon include focal/extensive vascular remodeling and dissolution of thrombus. While there are conflicting reports regarding the possible impact of this IVUS finding on clinical outcomes, recent reports of DES have suggested its possible association with late adverse cardiac events including late stent thrombosis. In this paper, we review the incidence, location, underlying pathology, and possible clinical sequelae of late-acquired ISA, primarily focusing on that of DES.

Keywords
Ultrasonics;
Stent;
Thrombosis;
Apposition
Department
Dept. of Internal Medicine (내과학)
Publisher
School of Medicine
Citation
Cardiovascular Revascularization Medicine, Vol.10(4) : 236-246, 2009
Type
Article
ISSN
1553-8389
URI
http://kumel.medlib.dsmc.or.kr/handle/2015.oak/35369
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