title: Detection of very early stent healing after primary angioplasty: an optical coherence tomographic observational study of chromium cobaltum and first-generation drug-eluting stents. The DETECTIVE study.
abstract: BACKGROUND
  Lack of stent coverage appears to be associated with stent thrombosis, a problem of particular concern in patients with ST elevation myocardial infarction (STEMI).
  
  
  METHODS
  The DETECTIVE European Multicenter Registry was set up to address the early modality of stent healing in the setting of STEMI. The Registry compared, with an early optical coherence tomography (OCT) evaluation performed at 3-7 days, the patterns of coverage and apposition of the first generation of drug-eluting stents (DESs) and cobalt chromium non-drug-eluting stents (CCSs) that were deployed in culprit lesions and in non-culprit segments. The Registry included only patients with a multi-vessel disease to allow, at 3-7 days from the first angioplasty, a deferred OCT examination and a staged intervention in another vessel.
  
  
  RESULTS
  28 stented lesions (15 patients) eventually entered the final OCT assessment. 13 stents were first-generation DESs, while the remaining 15 were CCSs. 18 stents (64%) were deployed at culprit STEMI lesions, and the remaining 10 (36%) were deployed at non-culprit sites. The distribution of clinical and procedural variables in DES and CCS as well as in culprit and non-culprit sites was not different. In total, 27,019 struts were analysed in 28 stents. The percentage of stent uncoverage in the overall analysis was 11.7%, while the percentage of malapposition and that of struts covered with thrombus were 4.8% and 2.2%, respectively. A low percentage of strut uncoverage was found in all the four studied subgroups: DES 12.8%, CCS 10.9%, stents deployed in culprit lesions 13.2% and stents deployed in non-culprit lesions 8.7%.
  
  
  CONCLUSIONS
  In conclusion, our data show that in patients with STEMI, a very high percentage of stent struts is covered by an early thin rim of tissue within 7 days after stent positioning. The present data bring new insights in the mechanism and timing of strut coverage.
authors: Interventional Cardiology, San Giovanni Hospital, Rome, Italy. fprati@hsangiovanni.roma.it
authors: Francesco
authors: F
authors: Prati
authors: Filippo
authors: F
authors: Stazi
authors: Jaime
authors: J
authors: Dutary
authors: Alessio
authors: A
authors: La Manna
authors: Alessandro
authors: A
authors: Di Giorgio
authors: Tomasz
authors: T
authors: Pawlosky
authors: Nieves
authors: N
authors: Gonzalo
authors: Maria Elena
authors: ME
authors: Di Salvo
authors: Fabrizio
authors: F
authors: Imola
authors: Corrado
authors: C
authors: Tamburino
authors: Mario
authors: M
authors: Albertucci
authors: Fernando
authors: F
authors: Alfonso
mesh_terms: D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D002858:Chromium Alloys / Q000627:therapeutic use*; D023903:Coronary Restenosis / Q000517:prevention & control*; D054855:Drug-Eluting Stents; D005062:European Union; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D011446:Prospective Studies; D012042:Registries; D012307:Risk Factors; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014945:Wound Healing
chemical_list: D002858:Chromium Alloys