Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
ISSN-L : 1346-9843
Cardiovascular Intervention
Impact of Hinge Motion on In-Stent Restenosis After Sirolimus-Eluting Stent Implantation
Yasushi InoTakashi KuboHironori KitabataKunihiro ShimamuraYasutsugu ShionoMakoto OriiKeishi OkochiHiromichi SougawaTakashi TanimotoKenichi KomukaiKohei IshibashiShigeho TakaradaHiroko NakanishiAtsushi TanakaKeizo KimuraKumiko HirataMasato MizukoshiToshio ImanishiTakashi Akasaka
Author information
JOURNAL FREE ACCESS

2011 Volume 75 Issue 8 Pages 1878-1884

Details
Abstract

Background: A tortuous lesion with hinge motion is reportedly a risk factor for in-stent restenosis (ISR) after bare metal stent implantation. Sirolimus-eluting stents (SESs) implantation has dramatically reduced ISR. However, SES is a closed-cell design stent, which has low conformability and flexibility. Several studies have reported a relationship between tortuous lesions and stent fracture, which is one of the causes of ISR. The efficacy of SES in a tortuous lesion with hinge motion has not been fully evaluated. The aim of this study was to investigate the relationship between tortuous lesions and ISR after SES implantation. Methods and Results: Three year clinical follow-up data after SES implantation, including 6-9 month scheduled follow-up coronary angiography in 399 consecutive patients with 537 lesions, were obtained. Δangle was defined as the difference in the angle of the target lesion between the diastole and systole before the procedure. The incidence of ISR was 8.2%. The mean maximal angle and Δangle were larger in the ISR group (47±22° vs. 37±21°, P=0.004 and 20±13° vs. 13±10°, P<0.0001, respectively). Independent predictors of ISR were Δangle, hemodialysis, aortic ostium stenting, and diabetes mellitus. Hinge motion-associated ISR (Δangle ≥16°) occurred in 28 lesions: stent fracture in 9, stent recoil in 6, edge injury in 10, and others in 3. Conclusions: The amount of hinge motion in tortuous lesions should be considered in the selection of drug eluting stent types. (Circ J 2011; 75: 1878-1884)

Content from these authors
© 2011 THE JAPANESE CIRCULATION SOCIETY
Previous article Next article
feedback
Top