Key result
DES maintain high axial integrity with no difference in length change across five platforms.
Why the study?
Longitudinal stent deformation had been recently reported, but the axial integrity of different coronary drug-eluting stents in vivo was not well characterized.
Does the type of drug-eluting stent platform affect longitudinal stent deformation measured by IVUS in patients with de novo coronary lesions?
Observational (n=233)
Does the type of drug-eluting stent platform affect longitudinal stent deformation measured by IVUS in patients with de novo coronary lesions?
p-value: p=0.085
In vivo evaluation using IVUS demonstrates that modern drug-eluting stents maintain high axial integrity with only mild longitudinal deformation after implantation, which is similar across second-generation platforms.
Minimal deformation across DES platforms supports high axial integrity; leaves open whether platform choice affects clinical outcomes in complex lesions.
OBJECTIVE: To evaluate the axial integrity of different coronary stents using intravascular ultrasound (IVUS). BACKGROUND: Longitudinal stent deformation was recently reported. METHODS: Consecutive patients who underwent IVUS analysis after drug-eluting stent (DES) implantation for de novo coronary lesions were evaluated. Stent length was compared with label length for calculation of absolute change and relative difference (absolute change divided by label length). RESULTS: A total of 233 DES utilizing five different platforms were included. The median absolute change in stent length was 0.90 mm (interquartile range [IQR] 0.48-1.39) and the relative difference was 5.24% (IQR 2.55-8.29). There was no significant difference among the groups in median absolute or relative change: Cypher 0.89 mm/3.89%, Taxus 0.88 mm/5.39%, Endeavor 1.16 mm/6.77%, Xience V 0.86 mm/5.80%, and PROMUS Element 0.79 mm/5.34% (P = 0.085, P = 0.072, respectively). Multivariate logistic regression revealed that the Cypher stent was independently correlated with a lower change in length, whereas stent label length and deployment pressure were correlated with higher absolute change. CONCLUSION: The axial integrity of DES platforms examined in vivo was high, with only mild changes in stent length after implantation. While there are differences between first- and second-generation DES, axial integrity among second-generation DES was similar.
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Dvir et al. (2013) conducted an observational in de novo coronary lesions (n=233). Different drug-eluting stent platforms vs. Comparison among platforms (Cypher, Taxus, Endeavor, Xience V, PROMUS Element) was evaluated on Absolute change and relative difference in stent length compared with label length (p=0.085). Drug-eluting stent implantation demonstrated high axial integrity with a median absolute length change of 0.90 mm and no significant difference among five different platforms (P=0.085).
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