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Myeongki Hong - One of the best experts on this subject based on the ideXlab platform.

  • Long-term Clinical Outcomes of Drug-Eluting Stent Malapposition.
    Korean Circulation Journal, 2020
    Co-Authors: Seung Yul Lee, Gary S Mintz, Jung-sun Kim, Byeong-keuk Kim, Yangsoo Jang, Myeongki Hong
    Abstract:

    Previous pathologic, intravascular imaging, and clinical studies have investigated the association between adverse cardiac events and Stent Malapposition, including acute Stent Malapposition (ASM, that is detected at index procedure) and late Stent Malapposition (LSM, that is detected during follow-up) that can be further classified into late-persiStent Stent Malapposition (LPSM, ASM that remains at follow-up) or late-acquired Stent Malapposition (LASM, newly developed Stent Malapposition at follow-up that was not present immediately after index Stent implantation). ASM has not been associated with adverse cardiac events compared with non-ASM, even in lesions with large-sized Malapposition. The clinical outcomes of LSM may depend on its subtype. The recent intravascular ultrasound studies with long-term follow-up have consiStently demonstrated that LASM steadily increased the risk of thrombotic events in patients with first-generation drug-eluting Stents (DESs). This association has not yet been identified in LPSM. Accordingly, it is reasonable that approaches to Stent Malapposition should be based on its relationship with clinical outcomes. ASM may be tolerable after successful Stent implantation, whereas prolonged anti-thrombotic medications and/or percutaneous interventions to modify LASM may be considered in selected patients with first-generation DESs. However, these treatments are still questionable due to lack of firm evidences.

  • Severe acute Stent Malapposition follow-up: 3-month and 12-month serial quantitative analyses by optical coherence tomography
    International Journal of Cardiology, 2020
    Co-Authors: Sung Jin Hong, Jung-sun Kim, Byeong-keuk Kim, Yangsoo Jang, Donghoon Choi, Chul Min Ahn, Keun Hee Park, Myeongki Hong
    Abstract:

    Abstract Background Optical coherence tomography (OCT) was used to assess serial changes in severe acute Stent Malapposition (ASM) after drug-eluting Stent (DES) implantation. Methods The maximal depth and axial lengths of ASM after DES implantation were serially quantified at percutaneous coronary intervention (PCI), and at 3 and 12-month follow-up, for 100 lesions in 96 patients. Severe ASM was defined as a maximal malapposed depth ≥400 μm or maximal malapposed axial length ≥1 mm. Results Of the 100 lesions, 23 lesions (23%) had a severe ASM depth at PCI. At 3 months, the maximal depth decreased to Conclusion Half of the severe ASM cases resolved within 3 months, and another half resolved during 3–12 months of follow-up. Our findings provide a better understanding of the time-dependent natural course of severe ASM using OCT.

  • Severe Acute Stent Malapposition After Drug-Eluting Stent Implantation: Effects on Long-Term Clinical Outcomes.
    Journal of the American Heart Association, 2019
    Co-Authors: Seung Yul Lee, Jung-sun Kim, Byeong-keuk Kim, Yangsoo Jang, Donghoon Choi, Sung Jin Hong, Chul Min Ahn, Myeongki Hong
    Abstract:

    Background The effects of severe acute Stent Malapposition (ASM) after drug‐eluting Stent implantation on long‐term clinical outcomes are not clearly understood. We evaluated long‐term clinical out...

  • Long-Term Clinical Outcomes of Late Stent Malapposition Detected by Optical Coherence Tomography After Drug-Eluting Stent Implantation.
    Journal of the American Heart Association, 2019
    Co-Authors: Sung Jin Hong, Jung-sun Kim, Byeong-keuk Kim, Yangsoo Jang, Donghoon Choi, Chul Min Ahn, Myeongki Hong
    Abstract:

    Background The relationship between late Stent Malapposition (LSM) and adverse cardiovascular events is controversial. Studies are needed to evaluate long‐term (>5 years) clinical outcomes of LSM d...

  • Impact of late Stent Malapposition after drug-eluting Stent implantation on long-term clinical outcomes.
    Atherosclerosis, 2019
    Co-Authors: Seung Yul Lee, Jung-sun Kim, Byeong-keuk Kim, Yangsoo Jang, Donghoon Choi, Sung Jin Hong, Chul Min Ahn, Myeongki Hong
    Abstract:

    Abstract Background and aims The impact of late drug-eluting Stent (DES) Malapposition detected by optical coherence tomography (OCT) on long-term clinical outcomes has not been clearly established. We evaluated long-term clinical outcomes of late Stent Malapposition (LSM) detected by OCT in a qualified study population. Methods A total of 428 patients were selected from previous randomized OCT studies that evaluated the degree of strut coverage of different DESs at a 3–12-month follow-up OCT examination. These patients were assigned to one of two groups based on the presence (n = 136) or absence (n = 292) of LSM on follow-up OCT images (performed at 7.0 ± 3.4 months after DES implantation). The cumulative rates of composite events (cardiac death, target-vessel-related myocardial infarction, target-vessel revascularization, and Stent thrombosis) were compared between the two groups. Results During 73.7 ± 18.3 months of follow-up, cardiac death or (very) late Stent thrombosis did not occur in either group. The cumulative rate of composite events was similar among the patients in each group (6.2% in patients with LSM vs. 11.7% in those without LSM) [hazard ratio (HR) = 0.569, 95% confidence interval (CI) = 0.257–1.257, p = 0.163]. Target vessel-related myocardial infarction occurred in 0.7% of patients with LSM vs. 1.5% of those without LSM (HR = 0.521, 95% CI = 0.058–4.670, p = 0.560). Target-vessel revascularization was performed in 5.4% of patients with LSM vs. 10.2% of those without LSM (HR = 0.574, 95% CI = 0.246–1.343, p = 0.201). Conclusions Cardiac death or (very) late Stent thrombosis did not occur in patients with OCT-detected LSM during long-term follow-up. The presence of OCT-detected LSM was not associated with adverse clinical events.

Gary S Mintz - One of the best experts on this subject based on the ideXlab platform.

  • Long-term Clinical Outcomes of Drug-Eluting Stent Malapposition.
    Korean Circulation Journal, 2020
    Co-Authors: Seung Yul Lee, Gary S Mintz, Jung-sun Kim, Byeong-keuk Kim, Yangsoo Jang, Myeongki Hong
    Abstract:

    Previous pathologic, intravascular imaging, and clinical studies have investigated the association between adverse cardiac events and Stent Malapposition, including acute Stent Malapposition (ASM, that is detected at index procedure) and late Stent Malapposition (LSM, that is detected during follow-up) that can be further classified into late-persiStent Stent Malapposition (LPSM, ASM that remains at follow-up) or late-acquired Stent Malapposition (LASM, newly developed Stent Malapposition at follow-up that was not present immediately after index Stent implantation). ASM has not been associated with adverse cardiac events compared with non-ASM, even in lesions with large-sized Malapposition. The clinical outcomes of LSM may depend on its subtype. The recent intravascular ultrasound studies with long-term follow-up have consiStently demonstrated that LASM steadily increased the risk of thrombotic events in patients with first-generation drug-eluting Stents (DESs). This association has not yet been identified in LPSM. Accordingly, it is reasonable that approaches to Stent Malapposition should be based on its relationship with clinical outcomes. ASM may be tolerable after successful Stent implantation, whereas prolonged anti-thrombotic medications and/or percutaneous interventions to modify LASM may be considered in selected patients with first-generation DESs. However, these treatments are still questionable due to lack of firm evidences.

  • Ten-Year Clinical Outcomes of Late-Acquired Stent Malapposition After Coronary Stent Implantation
    Arteriosclerosis Thrombosis and Vascular Biology, 2020
    Co-Authors: Seung Yul Lee, Dukwoo Park, Gary S Mintz, Jung-sun Kim, Byeong-keuk Kim, Sung Jin Hong, Chul Min Ahn, Jung Min Ahn, Donghoon Choi
    Abstract:

    Objective: The goal of this study was to determine the impact of late-acquired Stent Malapposition (LASM) on long-term clinical outcomes in patients treated with coronary Stent implantation. Approa...

  • Characteristics of Earlier Versus Delayed Presentation of Very Late Drug-Eluting Stent Thrombosis: An Optical Coherence Tomographic Study.
    Journal of the American Heart Association, 2017
    Co-Authors: Seung Yul Lee, Gary S Mintz, Seung-ho Hur, Jung Min Ahn, So Yeon Choi, Sang Wook Kim, Jin Man Cho, Soon Jun Hong, Jin Won Kim, Young Joon Hong
    Abstract:

    Background The pathophysiology underlying very late drug‐eluting Stent (DES) thrombosis is not sufficiently understood. Using optical coherence tomography, we investigated characteristics of very late Stent thrombosis (VLST) according to different onset times. Methods and Results A total of 98 patients from 10 South Korean hospitals who underwent optical coherence tomography for evaluation of very late DES thrombosis were retrospectively included in analyses. VLST occurred at a median of 55.1 months after DES implantation. All patients were divided into 2 equal groups of earlier versus delayed presentation of VLST, according to median onset time. In total, 27 patients were treated with next‐generation DES and 71 with first‐generation DES. Based on optical coherence tomography findings at thrombotic sites, main VLST mechanisms were as follows, in descending order: neoatherosclerosis (34.7%), Stent Malapposition (33.7%), and uncovered struts without Stent Malapposition or evagination (24.5%). Compared with patients with earlier VLST, patients with delayed VLST had lower frequency of uncovered struts without Stent Malapposition or evagination (34.7% versus 14.3%, respectively; P =0.019). Conversely, the frequency of neoatherosclerosis was higher in patients with delayed versus earlier VLST (44.9% versus 24.5%, respectively; P =0.034). The frequency of Stent Malapposition was not different between patients with earlier and delayed VLST (34.7% versus 32.7%, respectively; P =0.831). The frequency of Stent Malapposition, evagination, and uncovered struts was still half of delayed VLST. Conclusions The pathological mechanisms of very late DES thrombosis changed over time. Delayed neointimal healing remained a substantial substrate for VLST, even long after DES implantation.

  • Predictors and Long-Term Clinical Impact of Acute Stent Malapposition: An Assessment of Dual Antiplatelet Therapy With Drug-Eluting Stents (ADAPT-DES) Intravascular Ultrasound Substudy.
    Journal of the American Heart Association, 2016
    Co-Authors: Bin Wang, Gary S Mintz, Bernhard Witzenbichler, Cristiano Freitas De Souza, D. Christopher Metzger, Michael J. Rinaldi, Peter L. Duffy, Giora Weisz, Thomas D. Stuckey, Bruce R. Brodie
    Abstract:

    BackgroundThe impact of acute Stent Malapposition (ASM) on long‐term clinical outcomes in patients undergoing percutaneous coronary intervention is still controversial. We sought to evaluate predic...

  • Drug-eluting Stent Malapposition and its relationship to drug-eluting Stent thrombosis
    Interventional Cardiology, 2012
    Co-Authors: Ning Guo, Gary S Mintz
    Abstract:

    Stent Malapposition (whether acute and persiStent, or late and acquired) is common, occurring in 10–20% of drug-eluting Stent implantations in stable patients and 30–40% of ST-elevated myocardial infarction patients. Acute Stent Malapposition is not a predictor of early Stent thrombosis. Conversely, late Stent Malapposition, especially the large late Stent Malapposition area, might be a cause of late Stent thrombosis and very late Stent thrombosis in some patients. Other causes such as vessel wall inflammation, positive vessel wall remodeling, in-Stent neoatherosclerosis with plaque rupture, Stent fracture and delayed re-endothelialization with uncovered Stent struts may also contribute to late and very late Stent thrombosis.

Seungjung Park - One of the best experts on this subject based on the ideXlab platform.

  • late and very late drug eluting Stent Malapposition
    Circulation-cardiovascular Interventions, 2010
    Co-Authors: Soojin Kang, Dukwoo Park, Seongwook Park, Gary S Mintz, Cheol Whan Lee, Seungwhan Lee, Younghak Kim, Kihoon Han, Jaejoong Kim, Seungjung Park
    Abstract:

    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...

  • late and very late drug eluting Stent Malapposition serial 2 year quantitative ivus analysis
    Circulation-cardiovascular Interventions, 2010
    Co-Authors: Soojin Kang, Dukwoo Park, Seongwook Park, Gary S Mintz, Cheol Whan Lee, Seungwhan Lee, Younghak Kim, Kihoon Han, Jaejoong Kim, Seungjung Park
    Abstract:

    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.

  • Late and Very Late Drug-Eluting Stent MalappositionClinical Perspective: Serial 2-Year Quantitative IVUS Analysis
    Circulation: Cardiovascular Interventions, 2010
    Co-Authors: Soojin Kang, Dukwoo Park, Seongwook Park, Gary S Mintz, Cheol Whan Lee, Seungwhan Lee, Younghak Kim, Kihoon Han, Jaejoong Kim, Seungjung Park
    Abstract:

    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 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.

  • Very late Stent thrombosis of sirolimus-eluting Stent combined with late Stent Malapposition and aneurysm formation.
    The Journal of invasive cardiology, 2009
    Co-Authors: Sun-yang Min, Younghak Kim, Seungjung Park
    Abstract:

    Late complications of drug-eluting Stent, such as Stent Malapposition or aneurysm formation have emerged major concern. However, there is no available standard therapeutic guideline about them because the clinical course of those is variable and long-term follow- up data is not sufficient. A case presented here is acute ST-elevation myocardial infarction as a result of very late Stent thrombosis developed in a patient with Stent Malapposition and peri-Stent aneurysm formation 52 months after sirolimus-eluting Stent implantation. In conclusion, more careful long-term follow-up studies are required to access the significance of these late vascular pathologic changes.

  • late Stent Malapposition after drug eluting Stent implantation an intravascular ultrasound analysis with long term follow up
    Circulation, 2006
    Co-Authors: Myeongki Hong, Kyoungmin Park, Sangsig Cheong, Dukhyun Kang, Jongmin Song, Jaekwan Song, Dukwoo Park, Seongwook Park, Gary S Mintz, Seungjung Park
    Abstract:

    Background— Late Stent Malapposition (LSM) after drug-eluting Stent (DES) implantation has not been evaluated sufficiently in real-world practice. Methods and Results— We evaluated the incidence, mechanisms, predictors, and long-term prognosis of LSM after DES implantation in 557 patients (705 native lesions; sirolimus-eluting Stent in 538 lesions and paclitaxel-eluting Stent in 167 lesions) in whom intravascular ultrasound was performed at index and 6-month follow-up. LSM occurred in 82 patients with 85 lesions (12.1% overall, 95% CI 9.7% to 14.5%, 71 lesions (13.2%) in sirolimus-eluting Stents and 14 lesions [8.4%] in paclitaxel-eluting Stents, P=0.12]; the incidence was 25.0% (4/16) after directional coronary atherectomy before Stenting, 27.5% (14/51) in chronic total occlusion lesions, and 31.8% (7/22) after primary Stenting in acute myocardial infarction (P=0.13, P<0.001, and P=0.001, respectively, versus elective Stenting with conventional balloon predilation, 9.7% [60/616]). There was an increase o...

Dukwoo Park - One of the best experts on this subject based on the ideXlab platform.

  • Ten-Year Clinical Outcomes of Late-Acquired Stent Malapposition After Coronary Stent Implantation
    Arteriosclerosis Thrombosis and Vascular Biology, 2020
    Co-Authors: Seung Yul Lee, Dukwoo Park, Gary S Mintz, Jung-sun Kim, Byeong-keuk Kim, Sung Jin Hong, Chul Min Ahn, Jung Min Ahn, Donghoon Choi
    Abstract:

    Objective: The goal of this study was to determine the impact of late-acquired Stent Malapposition (LASM) on long-term clinical outcomes in patients treated with coronary Stent implantation. Approa...

  • late and very late drug eluting Stent Malapposition
    Circulation-cardiovascular Interventions, 2010
    Co-Authors: Soojin Kang, Dukwoo Park, Seongwook Park, Gary S Mintz, Cheol Whan Lee, Seungwhan Lee, Younghak Kim, Kihoon Han, Jaejoong Kim, Seungjung Park
    Abstract:

    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...

  • late and very late drug eluting Stent Malapposition serial 2 year quantitative ivus analysis
    Circulation-cardiovascular Interventions, 2010
    Co-Authors: Soojin Kang, Dukwoo Park, Seongwook Park, Gary S Mintz, Cheol Whan Lee, Seungwhan Lee, Younghak Kim, Kihoon Han, Jaejoong Kim, Seungjung Park
    Abstract:

    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.

  • Late and Very Late Drug-Eluting Stent MalappositionClinical Perspective: Serial 2-Year Quantitative IVUS Analysis
    Circulation: Cardiovascular Interventions, 2010
    Co-Authors: Soojin Kang, Dukwoo Park, Seongwook Park, Gary S Mintz, Cheol Whan Lee, Seungwhan Lee, Younghak Kim, Kihoon Han, Jaejoong Kim, Seungjung Park
    Abstract:

    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 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.

  • late Stent Malapposition after drug eluting Stent implantation an intravascular ultrasound analysis with long term follow up
    Circulation, 2006
    Co-Authors: Myeongki Hong, Kyoungmin Park, Sangsig Cheong, Dukhyun Kang, Jongmin Song, Jaekwan Song, Dukwoo Park, Seongwook Park, Gary S Mintz, Seungjung Park
    Abstract:

    Background— Late Stent Malapposition (LSM) after drug-eluting Stent (DES) implantation has not been evaluated sufficiently in real-world practice. Methods and Results— We evaluated the incidence, mechanisms, predictors, and long-term prognosis of LSM after DES implantation in 557 patients (705 native lesions; sirolimus-eluting Stent in 538 lesions and paclitaxel-eluting Stent in 167 lesions) in whom intravascular ultrasound was performed at index and 6-month follow-up. LSM occurred in 82 patients with 85 lesions (12.1% overall, 95% CI 9.7% to 14.5%, 71 lesions (13.2%) in sirolimus-eluting Stents and 14 lesions [8.4%] in paclitaxel-eluting Stents, P=0.12]; the incidence was 25.0% (4/16) after directional coronary atherectomy before Stenting, 27.5% (14/51) in chronic total occlusion lesions, and 31.8% (7/22) after primary Stenting in acute myocardial infarction (P=0.13, P<0.001, and P=0.001, respectively, versus elective Stenting with conventional balloon predilation, 9.7% [60/616]). There was an increase o...

Seongwook Park - One of the best experts on this subject based on the ideXlab platform.

  • late and very late drug eluting Stent Malapposition
    Circulation-cardiovascular Interventions, 2010
    Co-Authors: Soojin Kang, Dukwoo Park, Seongwook Park, Gary S Mintz, Cheol Whan Lee, Seungwhan Lee, Younghak Kim, Kihoon Han, Jaejoong Kim, Seungjung Park
    Abstract:

    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...

  • late and very late drug eluting Stent Malapposition serial 2 year quantitative ivus analysis
    Circulation-cardiovascular Interventions, 2010
    Co-Authors: Soojin Kang, Dukwoo Park, Seongwook Park, Gary S Mintz, Cheol Whan Lee, Seungwhan Lee, Younghak Kim, Kihoon Han, Jaejoong Kim, Seungjung Park
    Abstract:

    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.

  • Late and Very Late Drug-Eluting Stent MalappositionClinical Perspective: Serial 2-Year Quantitative IVUS Analysis
    Circulation: Cardiovascular Interventions, 2010
    Co-Authors: Soojin Kang, Dukwoo Park, Seongwook Park, Gary S Mintz, Cheol Whan Lee, Seungwhan Lee, Younghak Kim, Kihoon Han, Jaejoong Kim, Seungjung Park
    Abstract:

    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 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.

  • late Stent Malapposition after drug eluting Stent implantation an intravascular ultrasound analysis with long term follow up
    Circulation, 2006
    Co-Authors: Myeongki Hong, Kyoungmin Park, Sangsig Cheong, Dukhyun Kang, Jongmin Song, Jaekwan Song, Dukwoo Park, Seongwook Park, Gary S Mintz, Seungjung Park
    Abstract:

    Background— Late Stent Malapposition (LSM) after drug-eluting Stent (DES) implantation has not been evaluated sufficiently in real-world practice. Methods and Results— We evaluated the incidence, mechanisms, predictors, and long-term prognosis of LSM after DES implantation in 557 patients (705 native lesions; sirolimus-eluting Stent in 538 lesions and paclitaxel-eluting Stent in 167 lesions) in whom intravascular ultrasound was performed at index and 6-month follow-up. LSM occurred in 82 patients with 85 lesions (12.1% overall, 95% CI 9.7% to 14.5%, 71 lesions (13.2%) in sirolimus-eluting Stents and 14 lesions [8.4%] in paclitaxel-eluting Stents, P=0.12]; the incidence was 25.0% (4/16) after directional coronary atherectomy before Stenting, 27.5% (14/51) in chronic total occlusion lesions, and 31.8% (7/22) after primary Stenting in acute myocardial infarction (P=0.13, P<0.001, and P=0.001, respectively, versus elective Stenting with conventional balloon predilation, 9.7% [60/616]). There was an increase o...

  • Late Stent Thrombosis Associated with Late Stent Malapposition after Drug-Eluting Stenting: A Case Report
    Korean Circulation Journal, 2006
    Co-Authors: Bong Ryong Choi, Cheol Whan Lee, Seongwook Park
    Abstract:

    We report here on one patient who suffered from acute myocardial infarction that was due to late Stent thrombosis, and this was associated with late Stent Malapposition very late (21 months) after the deployment of a paclitaxeleluting Stent and shortly after (7 days) the discontinuation of the aspirin therapy. The intravascular ultrasound examination revealed that the late Stent thrombosis was accompanied by late Stent Malapposition. This is a report on late Stent thrombosis associated with late Stent Malapposition after the successful implantation of a paclitaxeleluting Stent (PES). (Korean Circulation J 2006;36:472-475)