Objective: To evaluate those procedures in which drug eluting stents DES cannot be implanted and to identify the variables related with this fact.
Design: Prospective observational study.
Patients: A total of 1.323 consecutive lesions, in which we attempted to deliver DES in our hospital, between February 2002 and March 2005. We reviewed the proportion of implantation failures and related factors.
Results: In 21 (1.6%) of the 1.323 lesions, it was not possible to implant the DES (1.6%, 1.5% and 2.3% with Cypher, Taxus, and Janus, respectively; p = NS). The procedure could be performed successfully in 17 cases: 9 with a bare metal stent and 8 with only balloon treatment, whereas the procedure failed in 4 patients. Those patients in whom the DES implantation failure had a greater frequency of peripheral arteriopathy (30 vs 8%; p = 0.003), calcium angiography (76 vs 42%; p = 0.002), vessel tortuosity (71 vs 20%, p < 0.01) y and B2/C lesion type (100 vs 77%; p = 0.007). The independent predictors were: peripheral arteriopathy, calcium and vessel tortuosity. There were no periprocedural mayor cardiac events in the cases with failed delivery of the DES.
Conclusions: In our series, 1.6% of the DES could not be implanted. Some clinical variables, (peripheral arteriopathy) and angiographic (calcium and tortuosity), are associated to a greater risk of this occurring.