APRIL 23e26, 2013

ORAL

ABSTRACTS

polymer, but different platform. Occlusion of small side branch (SB)jailed by stent is considered to be a cause of myocardial infarction afterpercutaneous coronary intervention. We compared the frequency ofjailed small SB occlusion after stenting and clinical outcomes treatedwith TE and TL.

Methods: From January 2011 to January 2012, 51 patients (68year-old, 35% of female) were treated with TE (21 pts with 33stents) or TL (30 pts with 46 stents) at our hospital. The total of 85non-protected small SB (>0.5 and <1.5mm in diameter by visualestimation) were evaluated (34 in TE and 51 in TL). SB occlusionwas defined as Thrombolysis in Myocardial Infarction flow grade0 or 1.

Results: Baseline characteristics and angiographic findings weresimilar between 2 groups. Small SB occlusion occurred in 0 patients inTE (0%) and 4 patients in TL (7.8%) after stenting (p¼0.15). None ofpatients have had cardiac death in hospital.

Conclusion: TE tends to have lower incidence of SB occlusion thanPL. The difference of platform, such as metal components, structuresand strut thickness may be able to influence initial angiographicoutcomes especially in small side branch occlusions.

- AS-057

Longitudinal Drug Eluting Stent Elongation Phenomenon afterHigh Pressure Additional Dilatation; Insights from BenchTesting. Takenori Domei, Kisaki Amemiyaa, Tomoaki Ito,Hiroyoshi Yokoi, Masashi Iwabuchi, Masakiyo Nobuyoshi. KokuraMemorial Hospital, Kitakyusyu, Japan.

Background: Stent longitudinal deformation was one of the clinicalissue in percutaneous coronary intervention. The aim of this study wasto evaluate how post stent dilatation with large balloon has impact onstent elongation.

Methods: Four types of drug eluting stents were deployed into themodel as shown Fig 1. Then, post stent dilatation was performedwith four different kinds of 3.5mm balloon at nominal and ratedpressure. A total of 16 stents were tested to evaluate stentelongation.

Results: The stent length post stent dilatation at nominal and ratedpressure was 0.40◇0.2mm and 1.04◇0.4mm, respectively. Significantdifference of stent length between the three types of post stent balloonswere found (Shown in Fig.2).

Conclusion: Stent elongation after post dilatation was observed inthis study. Degree of stent elongation after post stent dilatation mainlydepends on balloon types and pressure.

The American Journal of Cardiology� APRIL 23e26, 2013 AN

- AS-058

Impact of Longitudinal Stent Elongation During PercutaneousCoronary Intervention. Akihiko Matsumura. Kameda MedicalCenterl, Kamogwa, Japan.

Background: Longitudinal stent deformation is one of the hottesttopics these days. We met stent elongation during percutaneous coro-nary intervention (PCI). The bench test was done to clarify the stentelongation during PCI.

Methods: Case1. A 65 y/o male with history of stent implantation inthe left anterior descending artery underwent PCI for in-stent restenosis.After the predilatation using 3.5 x 20 mm balloon, a 3.0 x33 mm XiencePRIME stent was deployed at 14 atm with the full coverage of previ-ously implanted stent. Intravasucular ultrasound (IVUS) disclosed stentmalapposition at the proximal part of the stent and postdilatation wasperformed using predilated balloon catheter at 14 atm. After post-dilatation, stent got longer toward the proximal site and IVUS exami-nations detected stent elongation from 33.7mm to 37mm.

Case2. A 71 male with significant stenosis in the right coronaryartery underwent PCI. After the predilataion, a 3.5 x 24 mm TAXUSElement stent was deployed at 14 atm. IVUS examination detected stentmalapposition at the proximal part of the stent and postdilatation wasperformed using 4.5 x 8 mm high pressure balloon at 18 atm. FinalIVUS showed stent elongation 1.5mm toward the proximal site.

Results: A bench test was performed to confirm the stent elongation.A 3 x 28 mm stent was deployed in a silicone phantom at 16 atm andpostdilation was performed using semi-compliant balloon at 16 atm.Stent got longer more than 2 mm after postdilatation.

Conclusion: Coronary stent elongation is observed in a certainsituation during PCI.

- AS-154

National Heart Institute Registry of Coronary CatheterInterventions. Basem Enany1, Sameh Shaheen1, Wael Abdelshafee2,Hamdy Soliman2. 1Ainshams Univesity, Cairo, Egypt; 2National HeartInstitute, Cairo, Egypt.

Background: Besides being tools of epidemiological research, regis-tries have encountered new tasks in quality management as medicalpractice could be measured.

Methods: We established an electronic database for diagnostic andinterventional coronary artery procedures in National Heart Institute

GIOPLASTY SUMMIT ABSTRACTS/Oral 25B

APRIL 23e26, 2013

ORAL

ABSTRACTS

cath lab in Cairo, Egypt to allow assessment of adherence to currentinternational guidelines and comparing our patient’s outcomes withthose of other national and international registries.

Results: During the period from March 2008 to October 2009, 9059Coronary artery procedures had been registered (72.8% of all coronaryprocedures were diagnostic coronary angiographies and 27.2% werepercutaneous coronary interventions). Mean age was 51y and femaleswere 39.9%. Femoral approach was 99% of all cases.

About 15.2% of all coronary angiographies showed normal coro-naries. Among PCI population, 35.3% of patients were females. Priormyocardial infarction was registered in 12.3% of patients, whereas priorstroke was registered in 0.5% of them (0.2% in non-diabetics vs. 1.2%in diabetics).

The most frequently registered risk factor was smoking (63%).Hypertension was next common (57.7%). Diabetic patients hadsignificantly higher percentage of hypertension (65.4% in diabetics vs.50.5% in non-diabetics). About 25.3% of patients were diabetics.Hypertension and DM were more common among females. Electiveprocedures were 89.7% of coronary intervention procedures.

The most frequently tackled native coronary artery was LAD.During this period 3109 stents were used in our cath lab. Post-Inter-vention stenosis had been less than 50% in 93% of intervened lesions.Post-intervention TIMI flow was three in 91.2% of intervened lesions(90.2% of intervened lesions in Diabetics vs. 92.4% in non-diabetics).

Most frequently registered in-cath coronary artery complication wascoronary artery dissection (2.1% of tackled lesions). No Reflow wasregistered in 0.7% of tackled lesions.

Conclusion: It is not luxury for a cardiac cath lab to register cardiacintervention procedures especially coronary procedures being the mostfrequent procedures.

- AS-155

Off-hour Primary Percutaneous Coronary Angioplasty Does NotAffect Door to Balloon Time and Outcome.Mohammad Saifur Rohman, Doni Firman, Sunarya Soerianata,Nur Haryono. Harapan Kita Cardiovascular Hospital, Jakarta,Indonesia.

Background: Conflicting results exist on the door to balloon andoutcome of off-hour primary percutaneous coronary angioplasty (pPCI).This study therefore aims to evaluate the results of off-hours andregular-hour pPCI in Harapan Kita Cardiovascular Hospital.

Methods: This study included 238 consecutive ST ElevationMyocardial Infarction (STEMI) patients treated with pPCI from January2011 for 13 months. We examines differences in hospital eventsincluding heart failure, bleeding, arrhytmyas, contrast induced nephrop-athy, cerebrovascular complication and mortality among STEMI patientsundergoing pPCI during regular-hour (weekdays 8:00 AM to 4.00 PM)and off-hour (weekdays 16:01 PM to 7:59 AM, weekend, holidays).

Results: Overall, 185 (75.9%) patients underwent pPCI during off-hour. Baseline characteristics were comparable, no difference observedbetween off-hour and regular-hour pPCI in door to balloon (114.3 �64.4 vs. 100.5 � 45.3 minutes, p¼0.15) and procedure duration (41 �20 vs. 45 � 24 minutes, p¼0.32). No statistically significant differencealso observed in-hospital cardiovascular events, length of stay as well asin hospital mortality of patients treated with pPCI during off-hour orregular-hour.

Conclusion: Comparable door to balloon and outcomes wereobserved among STEMI patients underwent pPCI during off-hour andregular-hours.

26B The American Journal of Cardiology� APRIL

- AS-217

Flexibility and Stent Fracture Potentials Against Cyclically BendingCoronary Artery Motions: Comparison Between 2-Link and 3-LinkDESs. Kiyotaka Iwasaki, Sho Kishigami, Jun Arai, Takafumi Ohba,Xiaodong Zhu, Tadashi Yamamoto, Yutaka Hikichi, Mitsuo Umezu.Waseda University, Tokyo, Japan.

Background: Deployment of coronary stents in cyclically bendingcoronary artery often provokes changes in bending angles duringcardiac contraction and relaxation. Relationship between flexibilityagainst bending motions and stent fracture has not been well understoodyet. We investigated flexibility of 2-link and 3-link DESs in cyclicallybending coronary artery model. Moreover, stent fracture potentials bycyclically bending angulation ranges were investigated using a novelaccelerated durability tester capable of applying in-vivo simulatedcyclically bending angulations.

Methods: 1. Stent flexibility against bending motions Based onangiographic data of bending angles of proximal right coronary arteryin end-systole and end-diastole of 63 patients, the angle data classifiedin type-B according to ACC/AHA guideline were used for stentflexibility tests. Based on the data that the average angles in end-systole and end-diastole were 105� and 125�, elastic coronary arterymodels with an angulation of 125� and an inner diameter of 3mmwere manufactured. Mechanical stiffness of the coronary artery modelwas adjusted to that of referenced human coronary artery. Thecoronary artery models were cyclically bended between 105� and125�. Promus Element PtCr stents (2-link) (3020mm) and XiencePrime L605 CoCr stents (3-link) (3018mm) were deployed in thetransparent bending coronary artery models at each nominal ballooninflation pressure (n¼6 each). Angles at end-diastole, end-systole, anddifferences in the angles were analyzed using a digital microscope. 2.Stent fracture potentials by cyclically bending angulation ranges Stentfracture potentials under cyclically bending environments wereinvestigated using the accelerated durability tester. The bendingmotions were exerted 1200 times per minute to the stents deployed inthe coronary artery models filled with 37�C-controlled phosphatebuffered saline. The durability tests were conducted under severalangulation ranges. For the fracture-resistance tests, 2-link PromusElement PtCr stens and 3-link Xience L605 CoCr stents wereassessed.

Results: 1. Stent flexibility against bending motionsThere weredistinct differences in stent flexibility against cyclic bendingmotions between the two DES platforms. The angles at end-diastole, end-systole, differences in end-systole and end-diastolewere 116��1�, 132��1�, 16� for PtCr stent, and 136��3,148��4�, 12� for L605 CoCr stents. Both the angles at end-systole, end-diastole, and the differences in the angles of PtCrstent were closer to those of the pre-set bending artery model.These data suggested that PtCr 2-link stents had higher flexibilityat the bending lesion as compared with L605 CoCr stents. 2. Stentfracture potentials by cyclically bending angulation ranges Inseverer angulation ranges, 2-link PtCr stents had higher fracture-resistance as compared with 3-link CoCr stents. In mild angulationranges, both the stents had no fracture for one-year equivalentduration.

Conclusion: Stent flexibility against cyclically bending motions wasdifferent between 2-link stent and 3-link stent. Angulation range was aninfluential factor for stent fracture. The results indicated that the 2-linkstent having higher flexibility against cyclic bending motions had higherfracture-resistance against severer angulation ranges as compared withthe 3-link stent.

23e26, 2013 ANGIOPLASTY SUMMIT ABSTRACTS/Oral