title: Optical coherence tomography findings in lesions after sirolimus-eluting stent implantation with peri-stent contrast staining.
abstract: BACKGROUND
  We have sometimes noted abnormal angiographic coronary dilatation, <50% of the reference vessel, at the site of sirolimus-eluting stent implantation, suggesting contrast staining outside the stent struts and named this finding peri-stent contrast staining (PSS). Little was known about optical coherence tomography findings of lesions with PSS.
  
  
  RESULTS
  Between May 2008 and March 2010, we performed optical coherence tomography for 90 in-stent restenosis lesions after sirolimus-eluting stent implantation. We found PSS in 20 of the 90 lesions by coronary angiography. The differences in optical coherence tomography findings, including incomplete stent apposition, multiple interstrut hollows (MIH), strut coverage, and thrombus, were compared between lesions with PSS and those without PSS. PSS is defined as contrast staining outside the stent contour extending to >20% of the stent diameter measured by quantitative coronary angiography. MIH is defined as multiple hollows (the maximum depth >0.5 mm) existing between and outside well-apposed stent struts. Both incomplete stent apposition (60.0% versus 10%; P<0.001) and MIH (85.0% versus 25.7%; P<0.001) were frequently observed in lesions with PSS than in lesions without PSS. Among the 20 lesions with PSS, there was only 1 lesion in which we found neither MIH nor incomplete stent apposition, but only minor dissection. Uncovered struts (11.6% versus 3.9%; P=0.001), malapposed struts (2.0% versus 0.0%; P<0.001), and red thrombus (35% versus 10%; P=0.012) were frequently observed in lesions with PSS than in lesions without PSS.
  
  
  CONCLUSIONS
  PSS might be closely associated with 2 different optical coherence tomography findings, MIH and incomplete stent apposition, in lesions after sirolimus-eluting stent implantation.
authors.affiliation: Department of Cardiovascular Medicine, Kurashiki Central Hospital, Kurashiki, Japan. tadatakecirc@yahoo.co.jp
authors.forename: Takeshi
authors.initials: T
authors.lastname: Tada
authors.forename: Kazushige
authors.initials: K
authors.lastname: Kadota
authors.forename: Shingo
authors.initials: S
authors.lastname: Hosogi
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Kubo
authors.forename: Masatomo
authors.initials: M
authors.lastname: Ozaki
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Yoshino
authors.forename: Koshi
authors.initials: K
authors.lastname: Miyake
authors.forename: Haruki
authors.initials: H
authors.lastname: Eguchi
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Ohashi
authors.forename: Yuki
authors.initials: Y
authors.lastname: Hayakawa
authors.forename: Naoki
authors.initials: N
authors.lastname: Saito
authors.forename: Suguru
authors.initials: S
authors.lastname: Otsuru
authors.forename: Daiji
authors.initials: D
authors.lastname: Hasegawa
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Shigemoto
authors.forename: Seiji
authors.initials: S
authors.lastname: Habara
authors.forename: Masao
authors.initials: M
authors.lastname: Imai
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Tanaka
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Fuku
authors.forename: Naoki
authors.initials: N
authors.lastname: Oka
authors.forename: Harumi
authors.initials: H
authors.lastname: Kato
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yamamoto
authors.forename: Satoki
authors.initials: S
authors.lastname: Fujii
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Goto
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Mitsudo
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation*; D002317:Cardiovascular Agents / Q000008:administration & dosage*; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D023903:Coronary Restenosis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology; D003328:Coronary Thrombosis / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology; D003331:Coronary Vessels / Q000473:pathology*; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011237:Predictive Value of Tests; D011474:Prosthesis Design; D015203:Reproducibility of Results; D020123:Sirolimus / Q000008:administration & dosage*; D013997:Time Factors; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome
chemical_list: D002317:Cardiovascular Agents; D020123:Sirolimus