TCT-278 Two year Clinical Impact of Postprocedural Incomplete Stent Apposition and Late Acquired Incomplete Stent Apposition After Deployment of Zotarolimus Eluting Stent or Everolimus Eluting Stent

Abstract

Background: We already reported the preliminary data for the one year clinical impact of post-procedural incomplete stent apposition (PISA) and late incomplete stent apposition (LISA) in the newer generation of drug eluting stent. The aim of this study was to investigate the clinical impact of LISA and PISA during 24-month clinical follow up. Methods: We prospectively enrolled 178 patients who underwent percutaneous coronary intervention (PCI) in de novo coronary lesions; stable angina (n 41), unstable angina (n 91), and non-ST segment elevation myocardial infarction (n 46) (63.7 9.4 years, 125 male, 187 lesions). The group was randomly assigned (proportion of 1:2) to everolimus eluting stent (group I, n 65, Xience V, Abbott Vascular, Illinois) or zotarolimmus eluting stent (group II, n 122, Endeavor Resolute, Medtronic, MN). Post-PCI and follow up intravascular ultrasound (IVUS, mean 10.2 2.9 months) were performed in all patients. We analyzed 24-month major adverse cardiac events including death, myocardial infarction (MI) and target lesion failure (TLR). Results: The Post-PCI external elastic membrane (EEM) volume vs follow up EEM volume (group I: 368.0 169.6 mm vs 373.6 167.2 mm, p NS, group II: 431.0 167.5 vs 440.1 172.0 mm, p NS), and post-PCI lumen volume vs follow up lumen volume (group I: 203.0 86.8 vs 201.7 86.0 mm, p NS, group II: 239.2 92.7 vs 239.5 92.5 mm, p NS) by IVUS were not different. There were three LISAs [1.6%, group I (n 1) vs group II (n 2)] and sixty four PISAs [34.2%, group I (n 24 vs group II (n 40)] that were resolved [12.5%, group I (n 2) vs group II (n 6)]. Post-PCI and follow up volume of PISA was not significantly different in both group I (6.4 4.3 vs 6.3 3.9 mm, p NS) and group II (6.4 5.3 vs 6.2 4.3 mm, p NS). Both PISA and LISA were not related with cardiac death or MI during 24-month clinical follow up. However, there were four TLRs in PISA subgroup [6.3%, group I (n 0) vs group II (n 4)]. Conclusions: The incidence of LISA was low in both groups. Both PISA and LISA were not related with cardiac death or MI during 24-month clinical follow up. Future long-term follow up study to clarify the clinical course of LISA and PISA would be needed to confirm our results.