title: Angioscopic assessment of peri-stent contrast staining following drug-eluting stent implantation.
abstract: BACKGROUND
  Peri-stent contrast staining (PSS) has been recognized as a predictor of late stent thrombosis following drug-eluting stent (DES) implantation. However, the intravascular conditions at PSS sites remain unclear.
  
  
  RESULTS
  We evaluated 10 patients (median age 72 years, 80% male) with stable angina pectoris by coronary angioscopy. The patients had a total of 11 DES implantations (5 sirolimus-eluting stents; 4 paclitaxel-eluting stents; 2 everolimus-eluting stents) that showed PSS. Neointimal coverage (NIC), presence of thrombus, and yellow plaques underneath the stent were compared between PSS and non-PSS sites for each stent. NIC was graded as: grade 0, struts exposed; grade 1, struts bulging into the lumen, although covered; grade 2, struts embedded by neointima, but translucent; grade 3, struts fully embedded and invisible. Mean follow-up was 394±206 days (median: 289). NIC grade was lower at PSS sites (P=0.021) with 8 out of 11 stents (73%) having grade 0. Angioscopy detected a thrombus more frequently at PSS sites than at non-PSS sites (64% vs. 9%, P=0.012). Yellow plaques tended to be more significant at PSS sites than at non-PSS sites (82% vs. 45%, P=0.091).
  
  
  CONCLUSIONS
  The angioscopic findings suggest high thrombogenicity at PSS sites.
authors.affiliation: Kansai Rosai Hospital Cardiovascular Center.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Ishihara
authors.forename: Masaki
authors.initials: M
authors.lastname: Awata
authors.forename: Masashi
authors.initials: M
authors.lastname: Fujita
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Watanabe
authors.forename: Osamu
authors.initials: O
authors.lastname: Iida
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Ishida
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Nanto
authors.forename: Masaaki
authors.initials: M
authors.lastname: Uematsu
mesh_terms: D000368:Aged; D060050:Angina, Stable / Q000000981:diagnostic imaging / Q000628:therapy; D017023:Coronary Angiography; D054855:Drug-Eluting Stents; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology