The fate of incomplete stent apposition with drug-eluting stents: An optical coherence tomography-based natural history study

Yukio Ozaki, Masanori Okumura, Tevfik F. Ismail, Hiroyuki Naruse, Kousuke Hattori, Shino Kan, Makoto Ishikawa, Tomoko Kawai, Yasushi Takagi, Junichi Ishii, Francesco Prati, Patrick W. Serruys

Research output: Contribution to journalArticle

145 Citations (Scopus)

Abstract

Aims To assess the fate of incomplete stent apposition (ISA) after deployment of sirolimus-eluting stents (SESs).Methods and resultsThirty-two patients having intravascular ultrasound (IVUS)-guided PCI with SESs underwent assessment of stent deployment with quantitative coronary angiography, IVUS, and optical coherence tomography (OCT) pre-procedure, post-procedure, and at 10 months follow-up. Incomplete stent apposition was defined as separation of a stent strut from the inner vessel wall by >160 m. At follow-up, 4.67 of struts with ISA at deployment failed to heal and 7.59 which were well apposed did not develop neointimal hyperplasia even after 10 months. Lesion remodelling was responsible for the development of late ISA in only 0.37 of struts. Failure of adequate neointimal hyperplasia was quantitatively the most important mechanism responsible for persistent acute ISA, classified in previous studies, which relied only on follow-up OCT, as late ISA. Thrombus was visualized in 20.6 of struts with ISA at follow-up and in 2.0 of struts with a good apposition (P < 0.001).ConclusionIn patients with SESs, ISA can fail to heal and even complete apposition can be associated with no neointimal hyperplasia. Incomplete stent apposition without neointimal hyperplasia was significantly associated with the presence of OCT-detected thrombus at follow-up, and may constitute a potent substrate for late stent thrombosis.

Original languageEnglish
Pages (from-to)1470-1476
Number of pages7
JournalEuropean Heart Journal
Volume31
Issue number12
DOIs
Publication statusPublished - 01-06-2010

Fingerprint

Drug-Eluting Stents
Optical Coherence Tomography
Natural History
Stents
Hyperplasia
Sirolimus
Thrombosis
Coronary Angiography

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Ozaki, Yukio ; Okumura, Masanori ; Ismail, Tevfik F. ; Naruse, Hiroyuki ; Hattori, Kousuke ; Kan, Shino ; Ishikawa, Makoto ; Kawai, Tomoko ; Takagi, Yasushi ; Ishii, Junichi ; Prati, Francesco ; Serruys, Patrick W. / The fate of incomplete stent apposition with drug-eluting stents : An optical coherence tomography-based natural history study. In: European Heart Journal. 2010 ; Vol. 31, No. 12. pp. 1470-1476.
@article{2b5902c30dde4e9f9205e722e2a7d03f,
title = "The fate of incomplete stent apposition with drug-eluting stents: An optical coherence tomography-based natural history study",
abstract = "Aims To assess the fate of incomplete stent apposition (ISA) after deployment of sirolimus-eluting stents (SESs).Methods and resultsThirty-two patients having intravascular ultrasound (IVUS)-guided PCI with SESs underwent assessment of stent deployment with quantitative coronary angiography, IVUS, and optical coherence tomography (OCT) pre-procedure, post-procedure, and at 10 months follow-up. Incomplete stent apposition was defined as separation of a stent strut from the inner vessel wall by >160 m. At follow-up, 4.67 of struts with ISA at deployment failed to heal and 7.59 which were well apposed did not develop neointimal hyperplasia even after 10 months. Lesion remodelling was responsible for the development of late ISA in only 0.37 of struts. Failure of adequate neointimal hyperplasia was quantitatively the most important mechanism responsible for persistent acute ISA, classified in previous studies, which relied only on follow-up OCT, as late ISA. Thrombus was visualized in 20.6 of struts with ISA at follow-up and in 2.0 of struts with a good apposition (P < 0.001).ConclusionIn patients with SESs, ISA can fail to heal and even complete apposition can be associated with no neointimal hyperplasia. Incomplete stent apposition without neointimal hyperplasia was significantly associated with the presence of OCT-detected thrombus at follow-up, and may constitute a potent substrate for late stent thrombosis.",
author = "Yukio Ozaki and Masanori Okumura and Ismail, {Tevfik F.} and Hiroyuki Naruse and Kousuke Hattori and Shino Kan and Makoto Ishikawa and Tomoko Kawai and Yasushi Takagi and Junichi Ishii and Francesco Prati and Serruys, {Patrick W.}",
year = "2010",
month = "6",
day = "1",
doi = "10.1093/eurheartj/ehq066",
language = "English",
volume = "31",
pages = "1470--1476",
journal = "European Heart Journal",
issn = "0195-668X",
publisher = "Oxford University Press",
number = "12",

}

Ozaki, Y, Okumura, M, Ismail, TF, Naruse, H, Hattori, K, Kan, S, Ishikawa, M, Kawai, T, Takagi, Y, Ishii, J, Prati, F & Serruys, PW 2010, 'The fate of incomplete stent apposition with drug-eluting stents: An optical coherence tomography-based natural history study', European Heart Journal, vol. 31, no. 12, pp. 1470-1476. https://doi.org/10.1093/eurheartj/ehq066

The fate of incomplete stent apposition with drug-eluting stents : An optical coherence tomography-based natural history study. / Ozaki, Yukio; Okumura, Masanori; Ismail, Tevfik F.; Naruse, Hiroyuki; Hattori, Kousuke; Kan, Shino; Ishikawa, Makoto; Kawai, Tomoko; Takagi, Yasushi; Ishii, Junichi; Prati, Francesco; Serruys, Patrick W.

In: European Heart Journal, Vol. 31, No. 12, 01.06.2010, p. 1470-1476.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The fate of incomplete stent apposition with drug-eluting stents

T2 - An optical coherence tomography-based natural history study

AU - Ozaki, Yukio

AU - Okumura, Masanori

AU - Ismail, Tevfik F.

AU - Naruse, Hiroyuki

AU - Hattori, Kousuke

AU - Kan, Shino

AU - Ishikawa, Makoto

AU - Kawai, Tomoko

AU - Takagi, Yasushi

AU - Ishii, Junichi

AU - Prati, Francesco

AU - Serruys, Patrick W.

PY - 2010/6/1

Y1 - 2010/6/1

N2 - Aims To assess the fate of incomplete stent apposition (ISA) after deployment of sirolimus-eluting stents (SESs).Methods and resultsThirty-two patients having intravascular ultrasound (IVUS)-guided PCI with SESs underwent assessment of stent deployment with quantitative coronary angiography, IVUS, and optical coherence tomography (OCT) pre-procedure, post-procedure, and at 10 months follow-up. Incomplete stent apposition was defined as separation of a stent strut from the inner vessel wall by >160 m. At follow-up, 4.67 of struts with ISA at deployment failed to heal and 7.59 which were well apposed did not develop neointimal hyperplasia even after 10 months. Lesion remodelling was responsible for the development of late ISA in only 0.37 of struts. Failure of adequate neointimal hyperplasia was quantitatively the most important mechanism responsible for persistent acute ISA, classified in previous studies, which relied only on follow-up OCT, as late ISA. Thrombus was visualized in 20.6 of struts with ISA at follow-up and in 2.0 of struts with a good apposition (P < 0.001).ConclusionIn patients with SESs, ISA can fail to heal and even complete apposition can be associated with no neointimal hyperplasia. Incomplete stent apposition without neointimal hyperplasia was significantly associated with the presence of OCT-detected thrombus at follow-up, and may constitute a potent substrate for late stent thrombosis.

AB - Aims To assess the fate of incomplete stent apposition (ISA) after deployment of sirolimus-eluting stents (SESs).Methods and resultsThirty-two patients having intravascular ultrasound (IVUS)-guided PCI with SESs underwent assessment of stent deployment with quantitative coronary angiography, IVUS, and optical coherence tomography (OCT) pre-procedure, post-procedure, and at 10 months follow-up. Incomplete stent apposition was defined as separation of a stent strut from the inner vessel wall by >160 m. At follow-up, 4.67 of struts with ISA at deployment failed to heal and 7.59 which were well apposed did not develop neointimal hyperplasia even after 10 months. Lesion remodelling was responsible for the development of late ISA in only 0.37 of struts. Failure of adequate neointimal hyperplasia was quantitatively the most important mechanism responsible for persistent acute ISA, classified in previous studies, which relied only on follow-up OCT, as late ISA. Thrombus was visualized in 20.6 of struts with ISA at follow-up and in 2.0 of struts with a good apposition (P < 0.001).ConclusionIn patients with SESs, ISA can fail to heal and even complete apposition can be associated with no neointimal hyperplasia. Incomplete stent apposition without neointimal hyperplasia was significantly associated with the presence of OCT-detected thrombus at follow-up, and may constitute a potent substrate for late stent thrombosis.

UR - http://www.scopus.com/inward/record.url?scp=77953748337&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77953748337&partnerID=8YFLogxK

U2 - 10.1093/eurheartj/ehq066

DO - 10.1093/eurheartj/ehq066

M3 - Article

C2 - 20363765

AN - SCOPUS:77953748337

VL - 31

SP - 1470

EP - 1476

JO - European Heart Journal

JF - European Heart Journal

SN - 0195-668X

IS - 12

ER -