TY  - BOOK
AU  - Desale, Sameer
AU  - Laynez-Carnicero, Ana
AU  - Pakala, Rajbabu
AU  - Pichard, Augusto D
AU  - Romaguera, Rafael
AU  - Sardi, Gabriel L
AU  - Wakabayashi, Kohei
AU  - Waksman, Ron
AU  - Weissman, Neil J
AU  - Xue, Zhenyi
TI  - Impact of drug-eluting stents on distal vessels
SN  - 1941-7640
PY  - 2012///
KW  - *Blood Vessel Prosthesis Implantation
KW  - *Coronary Artery Disease/dt [Drug Therapy]
KW  - *Coronary Occlusion/dt [Drug Therapy]
KW  - *Drug-Eluting Stents/ae [Adverse Effects]
KW  - *Paclitaxel/ad [Administration & Dosage]
KW  - *Postoperative Complications/dt [Drug Therapy]
KW  - Aged
KW  - Coronary Artery Disease/pa [Pathology]
KW  - Coronary Artery Disease/su [Surgery]
KW  - Coronary Occlusion/pa [Pathology]
KW  - Coronary Occlusion/su [Surgery]
KW  - Female
KW  - Follow-Up Studies
KW  - Humans
KW  - Male
KW  - Middle Aged
KW  - Paclitaxel/ae [Adverse Effects]
KW  - Postoperative Complications/pa [Pathology]
KW  - Postoperative Complications/su [Surgery]
KW  - Ultrasonography, Interventional
KW  - Wound Healing
KW  - MedStar Heart & Vascular Institute
KW  - Comparative Study
KW  - Journal Article
KW  - Multicenter Study
KW  - Randomized Controlled Trial
KW  - Research Support, Non-U.S. Gov't
N1  - Available online from MWHC library: 2008 - present
N2  - BACKGROUND: Previous studies have not addressed vessel response >5 mm distal to the stent edge. Therefore, we investigated the impact of paclitaxel-eluting stents (PES) versus bare metal stents (BMS) on distal vessels in the serial intravascular ultrasound substudies of TAXUS IV, V, and VI; CLINICAL TRIAL REGISTRATION: URL: HTTP://WWW.CLINICALTRIAL.GOV. Unique identifiers: TAXUS IV: NCT00292474; TAXUS V: NCT00301522; TAXUS VI: NCT00297804; CONCLUSIONS: PES use was associated with plaque increase from baseline to 9-month follow-up >5 mm distal to the stent along with positive remodeling, whereas BMS use was associated with negative remodeling and no plaque increase. These vessel responses were consistent in 5-mm long subsegments: 0 to 5 mm versus 5 to 10 mm versus 10 to 15 mm distal to the stent; METHODS AND RESULTS: TAXUS IV, V, and VI were double-blind, randomized, multicenter, controlled trials comparing PES with BMS. In their intravascular ultrasound substudies, 103 patients (54 BMS, 49 PES) had intravascular ultrasound data >=10 mm distal to the stent both postprocedure and at 9 months follow-up. Baseline characteristics were similar between the 2 groups. Multilevel modeling was used to account for the variation between patients and within patients among distal segments. Effect of stent type, time, and their interaction was tested using a mixed effect model controlling for distal segments. Postprocedure lumen and vessel were not significantly different between PES versus BMS; however, lumen (P=0.006) and vessel (P=0.0001) were significantly reduced for BMS at 9-month follow-up but not for PES. Conversely, there was a significant plaque increase from postprocedure to 9-month follow-up for PES (P=0.0008) but not for BMS. These vessel responses were statistically consistent among 0- to 5-mm versus 5- to 10-mm versus 10- to 15-mm segments distal to the stent in both groups
UR  - http://dx.doi.org/10.1161/CIRCINTERVENTIONS.111.965780
ER  -