Intracoronary thrombus formation after drug-eluting stents implantation: optical coherence tomographic study.
BACKGROUND
Intracoronary thrombus formation after drug-eluting stent (DES) implantation is not sufficiently evaluated.


METHODS
Optical coherence tomography (OCT) was performed in 226 patients (total DES n = 244, sirolimus-eluting stent [SES] n = 95, paclitaxel-eluting stent [PES] n = 62, zotarolimus-eluting stent [ZES] n = 87) after implantation (mean 11 months, range 3-66 months). Using OCT, we investigated the incidence and determinants of intracoronary thrombus.


RESULTS
Intracoronary thrombus was detected in 35 (14%) cases (27 SES [28%], 7 PES [11%], and 1 ZES [1%], P < .001) and was associated with longer stent, smaller stent diameter, and stents at bifurcation lesions. More uncovered stent struts (26 +/- 23 vs 8 +/- 17, P < .001) and malapposed stent struts (6 +/- 14 vs 2 +/- 6, P < .001) were also associated with intracoronary thrombus. Multiple logistic regression analysis found the following determinants of intracoronary thrombus: stent length > or =28 mm (odds ratio [OR] 7.31, 95% CI 1.79-29.86, P = .01), stent diameter <3.0 mm (OR 4.38, 95% CI 1.38-13.97, P = .01), and > or =8 uncovered struts in each stent (OR 3.29, 95% CI 1.07-10.17, P = .04).


CONCLUSIONS
Length, size, and types of DES may be more important than clinical factors in intracoronary thrombus formation after DES implantations.
Kim
Jung-Sun
JS
Division of Cardiology, Yonsei Cardiovascular Center, Yonsei University College of Medicine, Seoul, South Korea.
Hong
Myeong-Ki
MK
Fan
Chunyu
C
Kim
Tae-Hoon
TH
Shim
Jae-Min
JM
Park
Sang-Min
SM
Ko
Young-Guk
YG
Choi
Donghoon
D
Jang
Yangsoo
Y
D003328:Coronary Thrombosis / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology*; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D041623:Tomography, Optical Coherence