title: Optical coherence tomography-based evaluation of malapposed strut coverage after drug-eluting stent implantation.
abstract: Minimal data exist regarding the use of optical coherence tomography (OCT) to evaluate malapposed strut coverage following implantation of drug-eluting stents (DESs). Follow-up OCT examination after DES implantation was performed in 368 patients with 406 lesions at our institute. We assessed the status of malapposed strut coverage that was identified via OCT in 92 (23 %) lesions. An absence of uncovered struts among malapposed struts was defined as completely covered (CC) malapposition; the presence of uncovered struts was defined as incompletely covered (IC) malapposition. Among the 92 lesions with malapposed DES struts, CC malapposition was detected in 47 lesions (51 %). Compared to lesions with IC malapposition (n = 45, 49 %), lesions with CC malapposition showed a significantly lower percentage of uncovered struts among all the struts (14.9 ± 14.5 vs. 4.4 ± 8.5 %, respectively, p < 0.001) and among the other well-apposed struts without malapposition (12.7 ± 12.8 vs. 4.5 ± 8.7 %, respectively, p = 0.001). The degree of malapposed strut coverage was significantly different according to the type of DES; new-generation DESs such as everolimus- or zotarolimus-eluting stents showed a higher incidence of CC malapposition, compared to first-generation DESs such as sirolimus- or paclitaxel-eluting stents (82 vs. 34 %, respectively, p < 0.001). This study showed the complete coverage in about 50 % of the lesions with malapposed DES struts on follow-up OCT. The degree of malapposed DES strut coverage was strongly affected by the type of implanted DESs.
authors.affiliation: Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, Seoul 120-752, Korea.
authors.forename: Byeong-Keuk
authors.initials: BK
authors.lastname: Kim
authors.forename: Dong-Ho
authors.initials: DH
authors.lastname: Shin
authors.forename: Jung-Sun
authors.initials: JS
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; D016009:Chi-Square Distribution; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000628:therapy*; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000473:pathology*; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation*; D011237:Predictive Value of Tests; D011474:Prosthesis Design; D012042:Registries; D013997:Time Factors; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome