title: Optical coherence tomography assessment of the acute effects of stent implantation on the vessel wall: a systematic quantitative approach.
abstract: OBJECTIVE
  To observe and characterise vessel injury after stenting using optical coherence tomography (OCT), to propose a systematic OCT classification for periprocedural vessel trauma, to evaluate its frequency in stable versus unstable patients and to assess its clinical impact during the hospitalisation period.
  
  
  METHODS
  Stenting causes vessel injury.
  
  
  METHODS
  All consecutive patients in whom OCT was performed after stent implantation were included in the study. Qualitative and quantitative assessment of tissue prolapse, intra-stent dissection and edge dissection were performed.
  
  
  RESULTS
  Seventy-three patients (80 vessels) were analysed. Tissue prolapse within the stented segment was visible in 78/80 vessels (97.5%). Median number of tissue prolapse sites was 8 (IQR 4-19), mean (SD) area 1.04 (0.9) mm(2). Intra-stent dissection flaps were visible in 69/80 vessels (86.3%) (median number 3 (IQR 1.25-6), maximum flap length 450 (220) microm). Fifty-five out of 80 vessels (68.8%) showed dissection cavities (median number 2 (IQR 0-4.75), maximum depth 340 (170) microm). Edge dissection was visible in 20 vessels (mean (SD) length flap 744 (439) microm). The frequency of tissue prolapse or intra-stent dissection was similar in stable and unstable patients (95.6% vs 100%, p = 0.5 for tissue prolapse; 91.1% vs 82.9%, p = 0.3 for intra-stent dissection). There were no events during the hospitalisation period.
  
  
  CONCLUSIONS
  OCT allows a detailed visualisation of vessel injury after stent implantation and enables a systematic classification and quantification in vivo. In this study, frequency of tissue prolapse or intra-stent dissections after stenting was high, irrespective of the clinical presentation of the patients, and was not associated with clinical events during hospitalisation.
authors: Thoraxcenter, Erasmus MC, 3015-CE Rotterdam, The Netherlands.
authors: N
authors: N
authors: Gonzalo
authors: P W
authors: PW
authors: Serruys
authors: T
authors: T
authors: Okamura
authors: Z J
authors: ZJ
authors: Shen
authors: Y
authors: Y
authors: Onuma
authors: H M
authors: HM
authors: Garcia-Garcia
authors: G
authors: G
authors: Sarno
authors: C
authors: C
authors: Schultz
authors: R J
authors: RJ
authors: van Geuns
authors: J
authors: J
authors: Ligthart
authors: E
authors: E
authors: Regar
mesh_terms: D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects*; D017023:Coronary Angiography; D003331:Coronary Vessels / Q000293:injuries*; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000473:pathology / Q000601:surgery*; D011391:Prolapse; D015607:Stents / Q000009:adverse effects*; D041623:Tomography, Optical Coherence; D017539:Tunica Intima / Q000473:pathology