title: Optical coherence tomography analysis of the stenting of saphenous vein graft (SOS) Xience V Study: use of the everolimus-eluting stent in saphenous vein graft lesions.
abstract: OBJECTIVE
  The Stenting of Saphenous Grafts-Xience V (SOS-Xience V) trial prospectively examined the frequency of angiographic in-stent restenosis in saphenous vein graft (SVG) lesions 12 months after implantation of a Xience V everolimus-eluting stent (EES; Abbott Vascular). Optical coherence tomography (OCT) during follow-up angiography was added to the protocol after OCT was approved for clinical use in the United States.
  
  
  METHODS
  Forty patients with 40 SVG lesions were enrolled in the study, of whom 27 underwent 12-month coronary angiography and 12 (only 1 of whom had in-stent restenosis) also had follow-up OCT evaluation. OCT strut-level analysis was performed to determine the percentage of strut coverage, malapposition, strut protrusion, neointimal thickness, and the existence of thrombus.
  
  
  RESULTS
  Mean patient age was 67 ± 7 years, and 95% were men. A total of 2584 struts were evaluated by OCT. The percentages for uncovered, malapposed, and protruding struts were 4%, 9%, and 15%, respectively. The mean strut neointimal thickness was 0.094 ± 0.094 mm. Of the 12 stents analyzed, 4 (33%) showed full neointimal coverage, 2 (17%) had all the struts embedded, 7 (58%) had at least 1 malapposed strut, and 10 (83%) had at least 1 protruding strut. The mean difference between the stent area and the lumen area was 0.36 ± 1.6 mm². No thrombus was detected in the stented areas.
  
  
  CONCLUSIONS
  Use of EES in SVGs is associated with high rates of stent strut coverage and high malapposition rates at 12 months post implantation.
authors.affiliation: VA North Texas Healthcare System, Dallas, Texas, USA.
authors.forename: Aristotelis C
authors.initials: AC
authors.lastname: Papayannis
authors.forename: Tesfaldet T
authors.initials: TT
authors.lastname: Michael
authors.forename: Dinara
authors.initials: D
authors.lastname: Yangirova
authors.forename: Abdul-Rahman
authors.initials: AR
authors.lastname: Abdel-Karim
authors.forename: Julia
authors.initials: J
authors.lastname: Kohlhaas
authors.forename: Arif
authors.initials: A
authors.lastname: Mahmood
authors.forename: Tayo
authors.initials: T
authors.lastname: Addo
authors.forename: Donald
authors.initials: D
authors.lastname: Haagen
authors.forename: Lorenza
authors.initials: L
authors.lastname: Makke
authors.forename: Michele
authors.initials: M
authors.lastname: Roesle
authors.forename: Bavana
authors.initials: B
authors.lastname: Rangan
authors.forename: Subhash
authors.initials: S
authors.lastname: Banerjee
authors.forename: Emmanouil S
authors.initials: ES
authors.lastname: Brilakis
mesh_terms: D000368:Aged; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000601:surgery*; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000601:surgery; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D000068338:Everolimus; D005260:Female; D006083:Graft Occlusion, Vascular / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods / Q000706:statistics & numerical data; D009204:Myocardial Revascularization / Q000009:adverse effects* / Q000379:methods; D058426:Neointima / Q000000981:diagnostic imaging / Q000503:physiopathology; D062645:Percutaneous Coronary Intervention / Q000379:methods; D011446:Prospective Studies; D018570:Risk Assessment / Q000379:methods; D012501:Saphenous Vein / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000637:transplantation; D020123:Sirolimus / Q000031:analogs & derivatives / Q000627:therapeutic use; D041623:Tomography, Optical Coherence / Q000379:methods / Q000706:statistics & numerical data; D016896:Treatment Outcome; D014654:Vascular Patency
chemical_list: D007166:Immunosuppressive Agents; D000068338:Everolimus; D020123:Sirolimus