BACKGROUND: Late stent thrombosis related to delayed neointimal growth is a major concern after drug-eluting stent (DES) implantation. The time course of neointimal growth and risk factors of uncovered stent struts after sirolimus-eluting stent (SES) was studied using optical coherence tomography (OCT). METHODS AND RESULTS: The 60 patients were enrolled and classified into G1 (follow-up period <9 months, n=27), G2 (9-24 months, n=18), and G3 (>25 months, n=15). The time elapsed since SES implantation was associated with a significant increase in mean neointimal area and neointimal thickness, and also with a significant decrease in the number of uncovered stent struts (G1: 14.8%, G2: 11.7%, and G3: 4.1%, P<0.001). However, only 17.6% of implanted SES was completely covered by neointima, even in the G3 period. Small-diameter SES, complex coronary lesions with lipid and calcium content adjacent to stent struts, and diabetes predicted delayed neointimal coverage of SES struts in G1. CONCLUSIONS: Neointima inside SES progressively increases after the routine follow-up period, but only a few SES were completely covered at 3 years after implantation. OCT is a useful modality for assessing neointimal formation after SES implantation, and may give important information about the strategy of antiplatelet therapy after DES implantation.
BACKGROUND: Late stent thrombosis related to delayed neointimal growth is a major concern after drug-eluting stent (DES) implantation. The time course of neointimal growth and risk factors of uncovered stent struts after sirolimus-eluting stent (SES) was studied using optical coherence tomography (OCT). METHODS AND RESULTS: The 60 patients were enrolled and classified into G1 (follow-up period <9 months, n=27), G2 (9-24 months, n=18), and G3 (>25 months, n=15). The time elapsed since SES implantation was associated with a significant increase in mean neointimal area and neointimal thickness, and also with a significant decrease in the number of uncovered stent struts (G1: 14.8%, G2: 11.7%, and G3: 4.1%, P<0.001). However, only 17.6% of implanted SES was completely covered by neointima, even in the G3 period. Small-diameter SES, complex coronary lesions with lipid and calcium content adjacent to stent struts, and diabetes predicted delayed neointimal coverage of SES struts in G1. CONCLUSIONS: Neointima inside SES progressively increases after the routine follow-up period, but only a few SES were completely covered at 3 years after implantation. OCT is a useful modality for assessing neointimal formation after SES implantation, and may give important information about the strategy of antiplatelet therapy after DES implantation.
Authors: Rodolfo Staico; Marco A Costa; Daniel Chamié; Hiram Bezerra; Luciana V Armaganijan; Ricardo A Costa; José Ribamar Costa; Dimytri Siqueira; Marinella Centemero; Áurea Chaves; Luiz Fernando Tanajura; Alexandre Abizaid; Fausto Feres; J Eduardo M R Sousa; Amanda G M R Sousa Journal: Int J Cardiovasc Imaging Date: 2013-03-03 Impact factor: 2.357
Authors: Juan Luis Gutiérrez-Chico; Eduardo Alegría-Barrero; Rodrigo Teijeiro-Mestre; Pak Hei Chan; Hiroto Tsujioka; Ranil de Silva; Nicola Viceconte; Alistair Lindsay; Tiffany Patterson; Nicolas Foin; Takashi Akasaka; Carlo di Mario Journal: Eur Heart J Cardiovasc Imaging Date: 2012-02-13 Impact factor: 6.875