Abstract 1929: Coronary Artery Aneurysms After Drug Eluting Stent Implantation: Real-World Incidence and Clinical Outcomes with Long-Term Follow-Up
Introduction; Coronary artery aneurysm(CAA) after drug-eluting stent(DES) implantation is rare complication and has not been evaluated sufficiently in real-world practice.
Methods and Resuts; We evaluated the incidence, clinical characteristics and long-term prognosis of CAA after DES implantation in 844 patients (1076 lesions;sirolimus-eluting stent in 734 lesions and paclitaxel-eluting stent in 342 lesions) in whom follow-up angiography was performed at 6-month. CAA occurred in 29 patients with 31 lesions(2.9% overall, 19 lesions [2.6%] in sirolimus-eluting stents and 12 lesions[3.5%] in paclitaxel-eluting stents, P=0.24); the incidence was 66%(19/29) in chronic total occlusions, and 20%(6/29)after primary stenting in acute myocardial infarction. The incidence of aneurysm types was 17%(5/29) for saccular form, 31%(9/29) for fusiform, and 52%(13/29) for microform. Independent predictors of CAA were chronic total occlusion lesions and acute myocardial infarction. Except for 1 late stent thrombosis in microform aneurysm after discontinuation of dual antiplatelet therapy, there were no major adverse cardiac events during a mean 18 month follow-up.
Conclusions; CAA occurs in about 3% of cases after DES implantation. The predictors of CAA are chronic total occlusion lesions and primary stenting in myocardial infarction. CAA after DES implantation seems to be not associated with major adverse cardiac events during a subsequent 18-months follow-up.