Comparison of stent axial integrity in first- versus second-generation drug-eluting stents: insights from intravascular ultrasound analysis

Abstract

Background: Longitudinal stent deformation (LSD) is a recently reported complication of coronary intervention. To date, however, the axial integrity of stents has not been systematically examined. This study aimed to assess the rate of LSD after implantation using intravascular ultrasound (IVUS). Methods: A total of 182 drug-eluting stents (DES) of 165 patients who underwent IVUS after implantation for de-novo lesions were included. Stent length was determined using automatic pullback device. The absolute value of the difference in length [IVUS - label], and the absolute value of the relative difference in length [(IVUS- label)/label] were analyzed. Results: Stent distribution was as follows: 38.4% sirolimus-eluting stents (SES); 18.7% paclitaxel-eluting stents (PES); 20.3% Cobalt-chromium everolimus-eluting stents (Cc-EES); and 22.5% Platinum-chromium everolimus-eluting stents (Pc-EES). The absolute difference in length did not differ among groups. There were no differences in the absolute value of the relative difference between the Pc-EES and any other stents. The absolute relative difference of >5% was lower in the SES group (p=0.027). Significant change (>15%) in length was low and similar among groups. ![Figure][1] Conclusions: This IVUS analysis proved that SES has the lowest differences in stent length and that there are no significant differences in axial stent integrity among PES and second-generation DES. The anecdotal reports of LSD are unsubstantiated in contemporary clinical practice. [1]: pending:yes