Abstract 12401: Prevention of Stent Grafts Restenosis by Pretreatment with Sirolimus Eluting Stent (SES)
Background: Stent grafts can be used for selected cases such as perforation, aneurysm, or severe late stent malapposition following drug eluting stent implantation. The main problem of stent grafts is restenosis from in-growth of neointima from stent edges.
Objectives: To assess the novel approach of combination of SES and stent graft for prevention of restenosis.
Methods: Between Jun 2008 and Dec 2010, 8 patients (2 for coronary perforation, 2 for aneurysm and 4 for late stent malapposition) were enrolled in this study. All culprit lesions were first treated with a longer SES (average length 29.9 mm and diameter 3.1mm) prior to implantation of a stent graft (average length 19.7 mm and diameter 3.4mm). All stents were fully expanded with high pressure post-dilatation. Coronary angiography and optical coherence tomography (OCT) were repeated at 8 month follow-up.
Results: There was no angiographic restenosis (% diameter stenosis was 15.2±14.2% at 8 months) in stent graft segment. Neointima thickness was significantly thinner in the stent graft (70.2±56.6), compared to that in the proximal SES (116.4±39.8) or in the distal SES segment (91.7±78.3)(P=0.002). No thrombus was observed with OCT at follow up.
Conclusions: There was no in-stent restenosis. Longer SES might have prevented in-growth of cells from stent edges. This double stent approach may be a viable option.
- © 2011 by American Heart Association, Inc.