title: Serial changes of minimal stent malapposition not detected by intravascular ultrasound: follow-up optical coherence tomography study.
abstract: Morphologic changes of small-sized post-stent malapposition have not been sufficiently evaluated. We investigated serial changes of minimal post-stent malapposition with a follow-up optical coherence tomography (OCT) study. Post-stent OCT and intravascular ultrasound (IVUS) and follow-up OCT were performed in 26 patients with minimal post-stent malapposition. Serial changes of number and percent of malapposition struts, and mean extra-stent malapposition area were measured in OCT analysis. Zotarolimus-eluting stent (ZES), sirolimus-eluting stent (SES), and paclitaxel-eluting stent (PES) were deployed in 17, 7 and 2 patients, respectively. Mean durations of the follow-up OCT study were 5.7 ± 3.0 months. The minimal post-stent malapposition cannot be detected by the IVUS, but be visualized with an OCT examination. According to different drug-eluting stents, malapposed stent struts were defined as the struts with detachment from the vessel wall ≥160 μm for SES, ≥130 μm for PES, and ≥110 μm for ZES. The percent of malapposition struts significantly decreased from 12.2 ± 11.0% post-stent to 1.0 ± 2.2% follow-up (P < 0.001). There was a significant decrease in the mean extra-stent malapposition area from 0.35 ± 0.16 mm(2) post-stent to 0.04 ± 0.11 mm(2) follow-up (P < 0.001). Complete disappearance of stent malapposition was also observed in 22 (85%) patients. In conclusion, minimal stent malapposition which is not detectable by IVUS may disappear or decrease in follow-up OCT evaluation.
authors.affiliation: Eulji University Hospital, Eulji University College of Medicine, Daejeon, Korea.
authors.forename: Won Ho
authors.initials: WH
authors.lastname: Kim
authors.forename: Byoung Kwon
authors.initials: BK
authors.lastname: Lee
authors.forename: Sahng
authors.initials: S
authors.lastname: Lee
authors.forename: Jae-Min
authors.initials: JM
authors.lastname: Shim
authors.forename: Jung-Sun
authors.initials: JS
authors.lastname: Kim
authors.forename: Byoung-Keuk
authors.initials: BK
authors.lastname: Kim
authors.forename: Young-Guk
authors.initials: YG
authors.lastname: Ko
authors.forename: Donghoon
authors.initials: D
authors.lastname: Choi
authors.forename: Yangsoo
authors.initials: Y
authors.lastname: Jang
authors.forename: Myeong-Ki
authors.initials: MK
authors.lastname: Hong
mesh_terms: D000368:Aged; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000628:therapy*; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure; D041623:Tomography, Optical Coherence; D018084:Ultrasonography, Interventional
references.citation: Eur Heart J. 2007 Apr;28(8):961-7
references.pmid: 17135281
references.citation: Circulation. 2007 May 8;115(18):2426-34
references.pmid: 17485593
references.citation: J Am Coll Cardiol. 2002 Feb 20;39(4):604-9
references.pmid: 11849858
references.citation: Eur Heart J. 2010 May;31(10):1172-80
references.pmid: 19158118
references.citation: Circulation. 2005 Feb 22;111(7):900-5
references.pmid: 15710761
references.citation: Cardiovasc Radiat Med. 2002 Jul-Dec;3(3-4):190-2
references.pmid: 12974372
references.citation: Circulation. 2002 Oct 1;106(14):1753-5
references.pmid: 12356624
references.citation: Circulation. 2004 Feb 17;109(6):701-5
references.pmid: 14744976
references.citation: EuroIntervention. 2007 May;3(1):128-36
references.pmid: 19737696
references.citation: Circulation. 2004 Feb 24;109(7):881-6
references.pmid: 14967732
references.citation: Int Heart J. 2005 Nov;46(6):1133-6
references.pmid: 16394609
references.citation: Circulation. 2006 Jan 24;113(3):414-9
references.pmid: 16432073
references.citation: Clin Res Cardiol. 2009 Sep;98(9):549-54
references.pmid: 19669824
references.citation: Heart. 2009 Dec;95(23):1907-12
references.pmid: 19535352
references.citation: J Invasive Cardiol. 2006 Sep;18(9):E238-40
references.pmid: 16954589
references.citation: J Am Coll Cardiol. 2006 Jul 4;48(1):193-202
references.pmid: 16814667
references.citation: Int J Cardiol. 2009 May 15;134(2):180-8
references.pmid: 18775576
references.citation: Circulation. 2007 Feb 27;115(8):1051-8
references.pmid: 17325255
references.citation: Circulation. 2007 May 8;115(18):2435-41
references.pmid: 17438147
references.citation: Clin Res Cardiol. 2009 Apr;98(4):240-8
references.pmid: 19219391
references.citation: Catheter Cardiovasc Interv. 2008 Aug 1;72(2):237-47
references.pmid: 18655155
references.citation: Heart. 2003 Mar;89(3):317-20
references.pmid: 12591841