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Gary S Mintz - One of the best experts on this subject based on the ideXlab platform.
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late and very late drug eluting stent malapposition
Circulation-cardiovascular Interventions, 2010Co-Authors: Soojin Kang, Dukwoo Park, Seongwook Park, Gary S Mintz, Cheol Whan Lee, Seungwhan Lee, Younghak Kim, Kihoon Han, Jaejoong Kim, Seungjung ParkAbstract:Background—The long-term natural history of acquired malapposition continues to be the subject of debate. Methods and Results—Using volumetric intravascular ultrasound analyses, we evaluated serial (poststenting, 6-month, and 2-year follow-up) changes in drug-eluting stent–treated vascular segments with acquired malapposition. External Elastic Membrane, stent, lumen, malapposition, and peristent plaque+media (P+M=external Elastic Membrane −stent− malapposition) areas were measured; and volumes were calculated and divided by stent length (normalized volume). Among 250 lesions in which complete serial intravascular ultrasound data were available, stent malapposition was identified in 19 lesions (7.6%) at 6 months, and an additional 13 malapposition lesions were newly detected at 2 years (5.2%). Because no malapposition sites resolved, the malapposition rate at 2 years was 12.8%. Malapposition areas and volumes were correlated to the increases in external Elastic Membrane (positive remodeling) throughout the...
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late and very late drug eluting stent malapposition serial 2 year quantitative ivus analysis
Circulation-cardiovascular Interventions, 2010Co-Authors: Soojin Kang, Dukwoo Park, Seongwook Park, Gary S Mintz, Cheol Whan Lee, Seungwhan Lee, Younghak Kim, Kihoon Han, Jaejoong Kim, Seungjung ParkAbstract:Background —The long-term natural history of acquired malapposition continues to be the subject of debate. Method and Results —Using volumetric intravascular ultrasound analyses, we evaluated serial (poststenting, 6-month, and 2-year follow-up) changes in drug-eluting stent–treated vascular segments with acquired malapposition. External Elastic Membrane, stent, lumen, malapposition, and peristent plaque+media (P+M=external Elastic Membrane –stent–malapposition) areas were measured; and volumes were calculated and divided by stent length (normalized volume). Among 250 lesions in which complete serial intravascular ultrasound data were available, stent malapposition was identified in 19 lesions (7.6%) at 6 months, and an additional 13 malapposition lesions were newly detected at 2 years (5.2%). Because no malapposition sites resolved, the malapposition rate at 2 years was 12.8%. Malapposition areas and volumes were correlated to the increases in external Elastic Membrane (positive remodeling) throughout the study period, from immediately after stenting to 6 months and from 6 months to 2 years, both in the group that developed malapposition at 6 months and in the group that developed malapposition at 2 years. Clinical follow-up beyond the 2 year intravascular ultrasound study was done in all patients. Overall, there were 2 cardiac deaths and 1 noncardiac death. Two patients presented with acute myocardial infarction associated with very late stent thrombosis (1 definite stent thrombosis, 1 probable stent thrombosis). Three patients underwent repeat revascularization owing to in-stent restenosis developed after the 2-year follow-up. Conclusions —Expansive vascular remodeling may play a role in the development and dynamic progression of acquired drug-eluting stent malapposition, not only during the first 6 months after implantation but thereafter.
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an integrated taxus iv v and vi intravascular ultrasound analysis of the predictors of edge restenosis after bare metal or paclitaxel eluting stents
American Journal of Cardiology, 2009Co-Authors: Akiko Maehara, Stephen G Ellis, Lazar Mandinov, Neil J. Weissman, Alan Yu, Eberhard Grube, Jeffrey J Popma, Gary S Mintz, Hong Wang, Keith D DawkinsAbstract:We used intravascular ultrasound data after stent implantation from the TAXUS IV, V, and VI trials to determine predictors of angiographic stent edge restenosis. In the combined TAXUS IV, V, and VI trials, intravascular ultrasound was performed at implantation in 255 patients with bare metals stents (BMSs) and 276 patients with paclitaxel-eluting stents who underwent quantitative coronary angiography at 9 months. At follow-up, 6 BMSs (2.5%) had proximal edge and 6 BMSs (2.4%) had distal edge angiographic restenosis; 14 TAXUS stents (5.2%) had proximal edge and 1 TAXUS stent (0.4%) had distal edge angiographic restenosis. Although univariate analysis identified external Elastic Membrane, lumen areas, and plaque burden (external Elastic Membrane minus lumen/ external Elastic Membrane) as predictors of 9-month angiographic edge restenosis in the overall cohort and in BMS- and TAXUS-treated patients separately, only edge plaque burden was an independent predictor of 9-month angiographic edge restenosis. Receiver operator characteristic analysis showed that residual plaque burden, but not edge lumen area, was predictive of 9-month angiographic edge restenosis in BMS-treated patients (cutoff 47.7%, c = 0.70, p = 0.0244) and in TAXUS-treated patients (cutoff 47.1%, c = 0.69, p = 0.0137). In conclusion, residual edge plaque burden predicts stent edge restenosis after BMS or TAXUS stent implantation and the optimal plaque burden for stent edge landing zones are the same for BMSs and TAXUS stents, independent of vessel size and edge lumen dimensions.
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association of plaque characterization by intravascular ultrasound virtual histology and arterial remodeling
American Journal of Cardiology, 2005Co-Authors: Kenichi Fujii, Gary S Mintz, Stéphane G. Carlier, William Wijns, Antonio Colombo, Dirk Böse, Raimund Erbel, Jose De Ribamar Costa, Masashi Kimura, Koichi SanoAbstract:Positive remodeling is more often observed in lesions of patients who have acute coronary syndromes or vulnerable (rupture-prone) plaques. However, there are few data that correlate plaque morphology, composition, and arterial remodeling in vivo. We evaluated coronary plaque characterization of lesions with positive remodeling using intravascular ultrasound (IVUS) radiofrequency data analysis. Seventy-seven nonbifurcation native coronary lesions (in 50 patients) were imaged in vivo using 30-MHz IVUS transducers. Lesions were classified into 4 plaque types, fibrous, fibrofatty, dense calcium, and necrotic core, by using processing of the radiofrequency signal validated in vitro. The remodeling index was calculated as the lesion external Elastic Membrane area divided by the proximal reference external Elastic Membrane area. Lesions were divided into 2 groups: positive remodeling (remodeling index >1.0, 26 lesions) and intermediate/negative remodeling (remodeling index <1.0, 51 lesions). Total plaque volume and the volume of each plaque type were averaged over the length of the lesion. Reference segment plaque compositions were similar. Mean lesion fibrofatty plaque area was significantly larger in lesions with positive remodeling than in lesions with intermediate/negative remodeling (1.2 0.7 vs 0.8 0.4 mm 2 ,p 0.001; 26.3 6.6% vs 19.8 5.7%, p <0.001, of total plaque volume). The same results were obtained at the minimum lumen site and in the subgroup of patients who had acute coronary syndromes. Further, there was a linear relation between remodeling index and fibrofatty plaque area (r 0.26, p 0.02). In conclusion, in vivo IVUS radiofrequency data analysis demonstrates that positive remodeling occurs in lesions with more fibrofatty plaque. © 2005 Elsevier Inc. All rights reserved. (Am J Cardiol 2005;96:1476‐1483)
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incidence mechanism predictors and long term prognosis of late stent malapposition after bare metal stent implantation
Circulation, 2004Co-Authors: Myeongki Hong, Dukhyun Kang, Jongmin Song, Jaekwan Song, Seongwook Park, Gary S Mintz, Seungjung ParkAbstract:Background— Predictors and long-term prognosis of late stent malapposition (LSM) after bare-metal stent (BMS) implantation are unknown. Methods and Results— We evaluated the incidence, mechanisms, predictors, and long-term prognosis of LSM after BMS implantation in 881 patients (992 native lesions) in whom intravascular ultrasound was performed at index and 6-month follow-up. LSM was defined as a separation of stent struts from the intimal surface of the arterial wall that was not presented at stent implantation. LSM occurred in 54 patients with 54 lesions (5.4% overall); the incidence was 10.3% (9 of 87) after directional coronary atherectomy (DCA) before stenting and 11.5% (11 of 96) after primary stenting in acute myocardial infarction (P=0.031 and P=0.007, respectively, versus elective stenting with conventional balloon pre-dilation, 4.3% [30 of 692]). There was an increase of external Elastic Membrane area (18.9±3.9 to 24.5±5.1 mm2, P<0.001) that was greater than the increase in plaque area (9.6±3.0 ...
Seungjung Park - One of the best experts on this subject based on the ideXlab platform.
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late and very late drug eluting stent malapposition
Circulation-cardiovascular Interventions, 2010Co-Authors: Soojin Kang, Dukwoo Park, Seongwook Park, Gary S Mintz, Cheol Whan Lee, Seungwhan Lee, Younghak Kim, Kihoon Han, Jaejoong Kim, Seungjung ParkAbstract:Background—The long-term natural history of acquired malapposition continues to be the subject of debate. Methods and Results—Using volumetric intravascular ultrasound analyses, we evaluated serial (poststenting, 6-month, and 2-year follow-up) changes in drug-eluting stent–treated vascular segments with acquired malapposition. External Elastic Membrane, stent, lumen, malapposition, and peristent plaque+media (P+M=external Elastic Membrane −stent− malapposition) areas were measured; and volumes were calculated and divided by stent length (normalized volume). Among 250 lesions in which complete serial intravascular ultrasound data were available, stent malapposition was identified in 19 lesions (7.6%) at 6 months, and an additional 13 malapposition lesions were newly detected at 2 years (5.2%). Because no malapposition sites resolved, the malapposition rate at 2 years was 12.8%. Malapposition areas and volumes were correlated to the increases in external Elastic Membrane (positive remodeling) throughout the...
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late and very late drug eluting stent malapposition serial 2 year quantitative ivus analysis
Circulation-cardiovascular Interventions, 2010Co-Authors: Soojin Kang, Dukwoo Park, Seongwook Park, Gary S Mintz, Cheol Whan Lee, Seungwhan Lee, Younghak Kim, Kihoon Han, Jaejoong Kim, Seungjung ParkAbstract:Background —The long-term natural history of acquired malapposition continues to be the subject of debate. Method and Results —Using volumetric intravascular ultrasound analyses, we evaluated serial (poststenting, 6-month, and 2-year follow-up) changes in drug-eluting stent–treated vascular segments with acquired malapposition. External Elastic Membrane, stent, lumen, malapposition, and peristent plaque+media (P+M=external Elastic Membrane –stent–malapposition) areas were measured; and volumes were calculated and divided by stent length (normalized volume). Among 250 lesions in which complete serial intravascular ultrasound data were available, stent malapposition was identified in 19 lesions (7.6%) at 6 months, and an additional 13 malapposition lesions were newly detected at 2 years (5.2%). Because no malapposition sites resolved, the malapposition rate at 2 years was 12.8%. Malapposition areas and volumes were correlated to the increases in external Elastic Membrane (positive remodeling) throughout the study period, from immediately after stenting to 6 months and from 6 months to 2 years, both in the group that developed malapposition at 6 months and in the group that developed malapposition at 2 years. Clinical follow-up beyond the 2 year intravascular ultrasound study was done in all patients. Overall, there were 2 cardiac deaths and 1 noncardiac death. Two patients presented with acute myocardial infarction associated with very late stent thrombosis (1 definite stent thrombosis, 1 probable stent thrombosis). Three patients underwent repeat revascularization owing to in-stent restenosis developed after the 2-year follow-up. Conclusions —Expansive vascular remodeling may play a role in the development and dynamic progression of acquired drug-eluting stent malapposition, not only during the first 6 months after implantation but thereafter.
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incidence mechanism predictors and long term prognosis of late stent malapposition after bare metal stent implantation
Circulation, 2004Co-Authors: Myeongki Hong, Dukhyun Kang, Jongmin Song, Jaekwan Song, Seongwook Park, Gary S Mintz, Seungjung ParkAbstract:Background— Predictors and long-term prognosis of late stent malapposition (LSM) after bare-metal stent (BMS) implantation are unknown. Methods and Results— We evaluated the incidence, mechanisms, predictors, and long-term prognosis of LSM after BMS implantation in 881 patients (992 native lesions) in whom intravascular ultrasound was performed at index and 6-month follow-up. LSM was defined as a separation of stent struts from the intimal surface of the arterial wall that was not presented at stent implantation. LSM occurred in 54 patients with 54 lesions (5.4% overall); the incidence was 10.3% (9 of 87) after directional coronary atherectomy (DCA) before stenting and 11.5% (11 of 96) after primary stenting in acute myocardial infarction (P=0.031 and P=0.007, respectively, versus elective stenting with conventional balloon pre-dilation, 4.3% [30 of 692]). There was an increase of external Elastic Membrane area (18.9±3.9 to 24.5±5.1 mm2, P<0.001) that was greater than the increase in plaque area (9.6±3.0 ...
Hartmut Löwen - One of the best experts on this subject based on the ideXlab platform.
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Theory of active particle penetration through a planar Elastic Membrane
New Journal of Physics, 2019Co-Authors: Abdallah Daddi-moussa-ider, Andreas M. Menzel, Benno Liebchen, Hartmut LöwenAbstract:With the rapid advent of biomedical and biotechnological innovations, a deep understanding of the nature of interaction between nanomaterials and cell Membranes, tissues, and organs, has become increasingly important. Active penetration of nanoparticles through cell Membranes is a fascinating phenomenon that may have important implications in various biomedical and clinical applications. Using a fully analytical theory supplemented by particle-based computer simulations, the penetration process of an active particle through a planar two-dimensional Elastic Membrane is studied. The Membrane is modeled as a self-assembled sheet of particles, uniformly arranged on a square lattice. A coarse-grained model is introduced to describe the mutual interactions between the Membrane particles. The active penetrating particle is assumed to interact sterically with the Membrane particles. State diagrams are presented to fully characterize the system behavior as functions of the relevant control parameters governing the transition between different dynamical states. Three distinct scenarios are identified. These compromise trapping of the active particle, penetration through the Membrane with subsequent self-healing, in addition to penetration with permanent disruption of the Membrane. The latter scenario may be accompanied by a partial fragmentation of the Membrane into bunches of isolated or clustered particles and creation of a hole of a size exceeding the interaction range of the Membrane components. It is further demonstrated that the capability of penetration is strongly influenced by the size of the approaching particle relative to that of the Membrane particles. Accordingly, active particles with larger size are more likely to remain trapped at the Membrane for the same propulsion speed. Such behavior is in line with experimental observations. Our analytical theory is based on a combination of a perturbative expansion technique and a discrete-to-continuum formulation. It well describes the system behavior in the small-deformation regime. Particularly, the theory allows to determine the Membrane displacement of the particles in the trapping state.a#13; Our approach might be helpful for the prediction of the transition threshold between the trapping and penetration in real-space experiments involving motile swimming bacteria or artificial active particles.
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Theory of active particle penetration through a planar Elastic Membrane
New Journal of Physics, 2019Co-Authors: Abdallah Daddi-moussa-ider, Andreas M. Menzel, Benno Liebchen, Hartmut LöwenAbstract:With the rapid advent of biomedical and biotechnological innovations, a deep understanding of the nature of interaction between nanomaterials and cell Membranes, tissues, and organs, has become increasingly important. Active penetration of nanoparticles through cell Membranes is a fascinating phenomenon that may have important implications in various biomedical and clinical applications. Using a fully analytical theory supplemented by particle-based computer simulations, the penetration process of an active particle through a planar two-dimensional Elastic Membrane is studied. The Membrane is modeled as a self-assembled sheet of particles, uniformly arranged on a square lattice. A coarse-grained model is introduced to describe the mutual interactions between the Membrane particles. The active penetrating particle is assumed to interact sterically with the Membrane particles. State diagrams are presented to fully characterize the system behavior as functions of the relevant control parameters governing the transition between different dynamical states. Three distinct scenarios are identified. These compromise trapping of the active particle, penetration through the Membrane with subsequent self-healing, in addition to penetration with permanent disruption of the Membrane. The latter scenario is accompanied by a partial fragmentation of the Membrane and creation of a hole of a size exceeding the interaction range of the Membrane components. Our analytical theory is based on a combination of a perturbative expansion technique and a discrete-to-continuum formulation. Our approach might be helpful for the prediction of the transition threshold between the trapping and penetration in real-space experiments involving motile swimming bacteria or artificial active particles.
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axisymmetric flow due to a stokeslet near a finite sized Elastic Membrane
Journal of the Physical Society of Japan, 2019Co-Authors: Abdallah Daddimoussaider, Badr Kaoui, Hartmut LöwenAbstract:Elastic confinements play an important role in many soft matter systems and affect the transport properties of suspended particles in viscous flow. On the basis of low-Reynolds-number hydrodynamics...
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axisymmetric flow due to a stokeslet near a finite sized Elastic Membrane
arXiv: Fluid Dynamics, 2019Co-Authors: Abdallah Daddimoussaider, Badr Kaoui, Hartmut LöwenAbstract:Elastic confinements play an important role in many soft matter systems and affect the transport properties of suspended particles in viscous flow. On the basis of low-Reynolds-number hydrodynamics, we present an analytical theory of the axisymmetric flow induced by a point-force singularity (Stokeslet) directed along the symmetry axis of a finite-sized circular Elastic Membrane endowed with resistance toward shear and bending. The solution for the viscous incompressible flow surrounding the Membrane is formulated as a mixed boundary value problem, which is then reduced into a system of dual integral equations on the inner and outer sides of the domain boundary. We show that the solution of the elastohydrodynamic problem can conveniently be expressed in terms of a set of inhomogeneous Fredholm integral equations of the second kind with logarithmic kernel. Basing on the hydrodynamic flow field, we obtain semi-analytical expressions of the hydrodynamic mobility function for the translational motion perpendicular to a circular Membrane. The results are valid to leading-order in the ratio of particle radius to the distance separating the particle from the Membrane. In the quasi-steady limit, we find that the particle mobility near a finite-sized Membrane is always larger than that predicted near a no-slip disk of the same size. We further show that the bending-related contribution to the hydrodynamic mobility increases monotonically upon decreasing the Membrane size, whereas the shear-related contribution displays a minimum value when the particle-Membrane distance is equal to the Membrane radius. Accordingly, the system behavior may be shear or bending dominated, depending on the geometric and Elastic properties of the system. Our results may find applications in the field of nanoparticle-based sensing and drug delivery systems near Elastic cell Membranes.
Erich Cosmi - One of the best experts on this subject based on the ideXlab platform.
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fetal aorta wall inflammation in ultrasound detected aortic intima media thickness and growth retardation
Journal of Reproductive Immunology, 2011Co-Authors: Vincenza Rita Lo Vasco, Roberto Salmaso, Vincenzo Zanardo, Rita Businaro, Silvia Visentin, Daniele Trevisanuto, Erich CosmiAbstract:Several studies have reported that fetuses with intrauterine growth restriction (IUGR) and infants with low birth weight present increased intima/media thickness (aIMT) of the abdominal aorta wall compared with fetuses and infants appropriate for gestational age (AGA). Evidence suggested that aIMT might be related to inflammation, probably indicating a very early stage of future adulthood disease, such as atherosclerosis. We aimed to investigate histological findings in the abdominal aorta wall of one IUGR stillbirth in which ultrasound had detected aIMT. Microscopy observations of the abdominal aorta wall confirmed the intima thickening and detected condensation of the Elastic fibers forming an evident internal Elastic Membrane and presence of inflammatory elements, such as macrophages, activated endothelial cells, and fibroblastoid cells. The present study highlights that IUGR associated with aIMT is related to inflammation, which might represent a very early sign of future adult lesions.
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fetal aorta wall inflammation in ultrasound detected aortic intima media thickness and growth retardation
Journal of Reproductive Immunology, 2011Co-Authors: Vincenza Rita Lo Vasco, Roberto Salmaso, Vincenzo Zanardo, Rita Businaro, Silvia Visentin, Daniele Trevisanuto, Erich CosmiAbstract:Abstract Several studies have reported that fetuses with intrauterine growth restriction (IUGR) and infants with low birth weight present increased intima/media thickness (aIMT) of the abdominal aorta wall compared with fetuses and infants appropriate for gestational age (AGA). Evidence suggested that aIMT might be related to inflammation, probably indicating a very early stage of future adulthood disease, such as atherosclerosis. We aimed to investigate histological findings in the abdominal aorta wall of one IUGR stillbirth in which ultrasound had detected aIMT. Microscopy observations of the abdominal aorta wall confirmed the intima thickening and detected condensation of the Elastic fibers forming an evident internal Elastic Membrane and presence of inflammatory elements, such as macrophages, activated endothelial cells, and fibroblastoid cells. The present study highlights that IUGR associated with aIMT is related to inflammation, which might represent a very early sign of future adult lesions.
Seongwook Park - One of the best experts on this subject based on the ideXlab platform.
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late and very late drug eluting stent malapposition
Circulation-cardiovascular Interventions, 2010Co-Authors: Soojin Kang, Dukwoo Park, Seongwook Park, Gary S Mintz, Cheol Whan Lee, Seungwhan Lee, Younghak Kim, Kihoon Han, Jaejoong Kim, Seungjung ParkAbstract:Background—The long-term natural history of acquired malapposition continues to be the subject of debate. Methods and Results—Using volumetric intravascular ultrasound analyses, we evaluated serial (poststenting, 6-month, and 2-year follow-up) changes in drug-eluting stent–treated vascular segments with acquired malapposition. External Elastic Membrane, stent, lumen, malapposition, and peristent plaque+media (P+M=external Elastic Membrane −stent− malapposition) areas were measured; and volumes were calculated and divided by stent length (normalized volume). Among 250 lesions in which complete serial intravascular ultrasound data were available, stent malapposition was identified in 19 lesions (7.6%) at 6 months, and an additional 13 malapposition lesions were newly detected at 2 years (5.2%). Because no malapposition sites resolved, the malapposition rate at 2 years was 12.8%. Malapposition areas and volumes were correlated to the increases in external Elastic Membrane (positive remodeling) throughout the...
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late and very late drug eluting stent malapposition serial 2 year quantitative ivus analysis
Circulation-cardiovascular Interventions, 2010Co-Authors: Soojin Kang, Dukwoo Park, Seongwook Park, Gary S Mintz, Cheol Whan Lee, Seungwhan Lee, Younghak Kim, Kihoon Han, Jaejoong Kim, Seungjung ParkAbstract:Background —The long-term natural history of acquired malapposition continues to be the subject of debate. Method and Results —Using volumetric intravascular ultrasound analyses, we evaluated serial (poststenting, 6-month, and 2-year follow-up) changes in drug-eluting stent–treated vascular segments with acquired malapposition. External Elastic Membrane, stent, lumen, malapposition, and peristent plaque+media (P+M=external Elastic Membrane –stent–malapposition) areas were measured; and volumes were calculated and divided by stent length (normalized volume). Among 250 lesions in which complete serial intravascular ultrasound data were available, stent malapposition was identified in 19 lesions (7.6%) at 6 months, and an additional 13 malapposition lesions were newly detected at 2 years (5.2%). Because no malapposition sites resolved, the malapposition rate at 2 years was 12.8%. Malapposition areas and volumes were correlated to the increases in external Elastic Membrane (positive remodeling) throughout the study period, from immediately after stenting to 6 months and from 6 months to 2 years, both in the group that developed malapposition at 6 months and in the group that developed malapposition at 2 years. Clinical follow-up beyond the 2 year intravascular ultrasound study was done in all patients. Overall, there were 2 cardiac deaths and 1 noncardiac death. Two patients presented with acute myocardial infarction associated with very late stent thrombosis (1 definite stent thrombosis, 1 probable stent thrombosis). Three patients underwent repeat revascularization owing to in-stent restenosis developed after the 2-year follow-up. Conclusions —Expansive vascular remodeling may play a role in the development and dynamic progression of acquired drug-eluting stent malapposition, not only during the first 6 months after implantation but thereafter.
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incidence mechanism predictors and long term prognosis of late stent malapposition after bare metal stent implantation
Circulation, 2004Co-Authors: Myeongki Hong, Dukhyun Kang, Jongmin Song, Jaekwan Song, Seongwook Park, Gary S Mintz, Seungjung ParkAbstract:Background— Predictors and long-term prognosis of late stent malapposition (LSM) after bare-metal stent (BMS) implantation are unknown. Methods and Results— We evaluated the incidence, mechanisms, predictors, and long-term prognosis of LSM after BMS implantation in 881 patients (992 native lesions) in whom intravascular ultrasound was performed at index and 6-month follow-up. LSM was defined as a separation of stent struts from the intimal surface of the arterial wall that was not presented at stent implantation. LSM occurred in 54 patients with 54 lesions (5.4% overall); the incidence was 10.3% (9 of 87) after directional coronary atherectomy (DCA) before stenting and 11.5% (11 of 96) after primary stenting in acute myocardial infarction (P=0.031 and P=0.007, respectively, versus elective stenting with conventional balloon pre-dilation, 4.3% [30 of 692]). There was an increase of external Elastic Membrane area (18.9±3.9 to 24.5±5.1 mm2, P<0.001) that was greater than the increase in plaque area (9.6±3.0 ...