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

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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.

元の言語English
ページ(範囲)1470-1476
ページ数7
ジャーナルEuropean heart journal
31
発行部数12
DOI
出版物ステータスPublished - 01-06-2010

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All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

これを引用

Ozaki, Y., Okumura, M., Ismail, T. F., Naruse, H., Hattori, K., Kan, S., Ishikawa, M., Kawai, T., Takagi, Y., Ishii, J., Prati, F., & Serruys, P. W. (2010). The fate of incomplete stent apposition with drug-eluting stents: An optical coherence tomography-based natural history study. European heart journal, 31(12), 1470-1476. https://doi.org/10.1093/eurheartj/ehq066