Serial changes of minimal stent malapposition not detected by intravascular ultrasound: follow-up optical coherence tomography study.
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.
Kim
Won Ho
WH
Eulji University Hospital, Eulji University College of Medicine, Daejeon, Korea.
Lee
Byoung Kwon
BK
Lee
Sahng
S
Shim
Jae-Min
JM
Kim
Jung-Sun
JS
Kim
Byoung-Keuk
BK
Ko
Young-Guk
YG
Choi
Donghoon
D
Jang
Yangsoo
Y
Hong
Myeong-Ki
MK
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
Eur Heart J. 2007 Apr;28(8):961-7
17135281
Circulation. 2007 May 8;115(18):2426-34
17485593
J Am Coll Cardiol. 2002 Feb 20;39(4):604-9
11849858
Eur Heart J. 2010 May;31(10):1172-80
19158118
Circulation. 2005 Feb 22;111(7):900-5
15710761
Cardiovasc Radiat Med. 2002 Jul-Dec;3(3-4):190-2
12974372
Circulation. 2002 Oct 1;106(14):1753-5
12356624
Circulation. 2004 Feb 17;109(6):701-5
14744976
EuroIntervention. 2007 May;3(1):128-36
19737696
Circulation. 2004 Feb 24;109(7):881-6
14967732
Int Heart J. 2005 Nov;46(6):1133-6
16394609
Circulation. 2006 Jan 24;113(3):414-9
16432073
Clin Res Cardiol. 2009 Sep;98(9):549-54
19669824
Heart. 2009 Dec;95(23):1907-12
19535352
J Invasive Cardiol. 2006 Sep;18(9):E238-40
16954589
J Am Coll Cardiol. 2006 Jul 4;48(1):193-202
16814667
Int J Cardiol. 2009 May 15;134(2):180-8
18775576
Circulation. 2007 Feb 27;115(8):1051-8
17325255
Circulation. 2007 May 8;115(18):2435-41
17438147
Clin Res Cardiol. 2009 Apr;98(4):240-8
19219391
Catheter Cardiovasc Interv. 2008 Aug 1;72(2):237-47
18655155
Heart. 2003 Mar;89(3):317-20
12591841