title: Outcomes of everolimus-eluting stent incomplete stent apposition: a serial optical coherence tomography analysis.
abstract: OBJECTIVE
  The aim of the present study was to evaluate the natural course of acute incomplete stent apposition (ISA) after second-generation everolimus-eluting stent (EES) when compared with first-generation sirolimus-eluting stent (SES) by using optical coherence tomography (OCT).
  
  
  RESULTS
  From the OCT substudy of the RESET trial, we identified 77 patients (EES = 38 and SES = 39) who successfully underwent serial OCT examination at post-stenting and 8-12-month follow-up. The presence of ISA was assessed in the OCT images, and ISA distance was measured from the centre of the strut blooming to the adjacent lumen border. Incomplete stent apposition was observed in all EES and SES at post-stenting, and it was persistent in 26% of EES and 38% of SES at 8-12-month follow-up. Maximum ISA distance was significantly decreased during the follow-up period in both EES (315 ± 94-110 ± 165 μm, P < 0.001) and SES (308 ± 119-143 ± 195 μm, P < 0.001). Receiver-operating curve analysis identified that the best cut-off value of OCT-estimated ISA distance at post-stenting for predicting late-persistent ISA at 8-12-month follow-up in EES and SES was >355 and >285 μm, respectively.
  
  
  CONCLUSIONS
  The second-generation EES showed better healing of acute ISA in comparison with the first-generation SES. Optical coherence tomography can predict late-persistent ISA after DES implantation and provide useful information to optimize PCI.
authors.affiliation: Department of Cardiovascular Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama, 641-8510, Japan.
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Shimamura
authors.affiliation: Department of Cardiovascular Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama, 641-8510, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Kubo
authors.affiliation: Department of Cardiovascular Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama, 641-8510, Japan akasat@wakayama-med.ac.jp.
authors.forename: Takashi
authors.initials: T
authors.lastname: Akasaka
authors.affiliation: Division of Cardiology, Teikyo University Hospital, Tokyo, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Kozuma
authors.affiliation: Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Kimura
authors.affiliation: Division of Cardiology, Yokkaichi Social Insurance Hospital, Yokkaichi, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Kawamura
authors.affiliation: Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Sumiyoshi
authors.affiliation: Department of Cardiovascular Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama, 641-8510, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Ino
authors.affiliation: Division of Internal Medicine and Cardiology, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Minoru
authors.initials: M
authors.lastname: Yoshiyama
authors.affiliation: Division of Cardiology, University of Occupational and Environmental Health Japan, Kitakyushu, Japan.
authors.forename: Shinjo
authors.initials: S
authors.lastname: Sonoda
authors.affiliation: Division of Cardiology, Hokkaido Social Insurance Hospital, Sapporo, Japan.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Igarashi
authors.affiliation: Division of Cardiology, Teikyo University Hospital, Tokyo, Japan.
authors.forename: Akiyoshi
authors.initials: A
authors.lastname: Miyazawa
authors.affiliation: Department of Cardiovascular Medicine, University of Fukui Hospital, Fukui, Japan.
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Uzui
authors.affiliation: Division of Cardiology, Higashisumiyoshi Morimoto Hospital, Osaka, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Sakanoue
authors.affiliation: Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Toshiro
authors.initials: T
authors.lastname: Shinke
authors.affiliation: Division of Cardiology, Tokai University Hospital, Kanagawa, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Morino
authors.affiliation: Division of Cardiology, Mitsui Memorial Hospital, Tokyo, Japan.
authors.forename: Kengo
authors.initials: K
authors.lastname: Tanabe
authors.affiliation: Division of Cardiology, Kurashiki Central Hospital, Kurashiki, Japan.
authors.forename: Kazushige
authors.initials: K
authors.lastname: Kadota
authors.affiliation: Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kimura
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000379:methods*; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000628:therapy*; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D000068338:Everolimus; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011475:Prosthesis Failure; D012372:ROC Curve; D018570:Risk Assessment; D020123:Sirolimus / Q000031:analogs & derivatives* / Q000494:pharmacology*; D041623:Tomography, Optical Coherence / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D000068338:Everolimus; D020123:Sirolimus
keywords: Drug-eluting stent; Incomplete stent apposition; Optical coherence tomography