Paul Yock, MD

Publication Details

  • Impact of final Stent dimensions on long-term results following sirolimus-eluting stent implantation - Serial intravascular ultrasound analysis from the SIRIUS trial JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY Sonoda, S., Morino, Y., Ako, J., Terashima, M., Hassan, A. H., Bonneau, H. N., Leon, M. B., Moses, J. W., Yock, P. G., Honda, Y., Kuntz, R. E., Fitzgerald, P. J. 2004; 43 (11): 1959-1963


    We assessed the predictive value of minimum stent area (MSA) for long-term patency of sirolimus-eluting stents (SES) implantation compared to bare metal stents (BMS).Although MSA is a consistent predictor of in-stent restenosis, its predictive value in BMS is still limited because of biologic variability in the restenosis process.From the SIRolImUS (SIRIUS) trial, 122 cases (SES: 72; BMS: 50) with complete serial intravascular ultrasound (IVUS) (baseline and 8-month follow-up) were analyzed. Postprocedure MSA and follow-up minimum lumen area (MLA) were obtained. Based on previous physiologic studies, adequate stent patency at follow-up was defined as MLA >4 mm(2).In both groups, a significant positive correlation was observed between baseline MSA and follow-up MLA (SES: p < 0.0001, BMS: p < 0.0001). However, SES showed higher correlation than BMS (0.8 vs. 0.65) with a higher regression coefficient (0.92 vs. 0.59). The sensitivity and specificity curves identified different optimal thresholds of MSA to predict adequate follow-up MLA: 5 mm(2) for SES and 6.5 mm(2) for BMS. The positive predictive values with these cutoff points were 90% and 56%, respectively.In this SIRIUS IVUS substudy, SES reduced both biologic variability and restenosis, resulting in increased predictability of long-term stent patency with postprocedure MSA. In addition, SES had a considerably lower optimal MSA threshold compared to BMS.

    View details for DOI 10.1016/j./jacc.2004.01.044

    View details for Web of Science ID 000221715800006

    View details for PubMedID 15172398

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