title: Evaluation neointimal coverage in patients with coronary artery aneurysm formation after drug-eluting stent implantation by optical coherence tomography.
abstract: The neointimal coverage in patients with coronary artery aneurysms (CAA) formation after drug eluting stent (DES) implantation is not clear. Total of 175 patients who had been implanted DES were identified. Patients were divided into the CAA group (n = 31) and non-CAA group (n = 144) based on the results of the coronary angiography. The cardiac events including angina and acute myocardial infarction were noted, in addition, the neointimal thickness and the frequence of strut malapposition and strut uncoverage were noted. A greater proportion of incomplete neointimal coverage (17.17 vs. 1.9%, P < 0.001) and malapposition struts (18.2 vs. 1.38%, P < 0.001) were observed in the CAA group. 8 patients in CAA group underwent OCT examination twice in the period of follow-up. The proportion of incomplete neointimal coverage increased significantly as compared the second OCT results with the first examination (18.45 vs. 2.66%, P < 0.001). Hyperplasia neointimal desquamated from struts and acquired struts incomplete neointimal coverage were detected. Patients with CAA had a higher frequency of cardiac events including angina pectoris (25.81 vs. 6.25%, P = 0.001) and acute myocardial infarction (9.68 vs. 0.13%, P = 0.002) and thrombosis (16.13 vs. 0.69%, P < 0.001). The longitudinal length of CAA in cardiac event group was significantly longer than no cardiac event group (20.0 ± 9.07 vs. 12.05 ± 5.38 mm, P = 0.005). CAA formation after DES implantation frequently associated with cardiac events as a result of stent malapposition and incomplete neointimal coverage. Acquired incomplete neointimal coverage associated with CAA formation.
authors.affiliation: Department of Cardiology, Chinese PLA General Hospital, Beijing, 100853, China.
authors.forename: Tian
authors.initials: T
authors.lastname: Feng
authors.forename: Chen
authors.initials: C
authors.lastname: Yundai
authors.forename: Liu
authors.initials: L
authors.lastname: Hongbin
authors.forename: Chen
authors.initials: C
authors.lastname: Lian
authors.forename: Sun
authors.initials: S
authors.lastname: Zhijun
authors.forename: Guo
authors.initials: G
authors.lastname: Jun
authors.forename: Jin
authors.initials: J
authors.lastname: Qinhua
authors.forename: Zhang
authors.initials: Z
authors.lastname: Tao
mesh_terms: D000368:Aged; D000787:Angina Pectoris / Q000209:etiology; D003323:Coronary Aneurysm / Q000209:etiology* / Q000473:pathology; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000628:therapy*; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000473:pathology*; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D006965:Hyperplasia; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D058426:Neointima; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects* / Q000295:instrumentation*; D011237:Predictive Value of Tests; D011474:Prosthesis Design; D041623:Tomography, Optical Coherence; D014945:Wound Healing
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