AIMS: We sought to evaluate the vascular response of stent struts deployed in bifurcation segments using optical coherence tomography (OCT). METHODS AND RESULTS: This study is a sub-analysis of ODESSA, a prospective randomised trial designed to evaluate healing of overlapped drug-eluting stents (DES) vs. bare metal stents (BMS) (sirolimus SES: paclitaxel PES: zotarolimus ZES: Liberté BMS in a 2: 2: 2: 1 ratio) for de novo coronary artery stenosis. OCT was performed at 6-month follow-up. Bifurcation segments with side branch diameters larger than 1.5mm by angiography were analysed. The cross-sectional image at the bifurcation segment was divided into three regions: opposite to the ostium (OO), adjacent to the ostium (AO), or side-branch ostium (SO). Struts were classified in three categories: uncovered (U), covered (C), or proliferative (P). The incidence of each strut category was compared between regions and stent types. There were 12,656 struts in 61 bifurcation segments (PES: 16, SES: 14, ZES: 23, Liberté BMS: 8) from 46 patients obtained at six months. PES had the highest rate of U in SO region (PES 60.1, SES 17.0, ZES 13.2, BMS 12.3 (%), P<0.0001), whereas SES demonstrated the highest rate of U in OO (PES 3.8, SES 14.0, ZES 1.5, BMS 0.0 (%), P=0.0025). CONCLUSIONS: This study demonstrates a variable pattern of strut coverage in the bifurcation among stent technologies, with a high percentage of PES floating struts remaining uncovered at 6-month follow-up.
RCT Entities:
AIMS: We sought to evaluate the vascular response of stent struts deployed in bifurcation segments using optical coherence tomography (OCT). METHODS AND RESULTS: This study is a sub-analysis of ODESSA, a prospective randomised trial designed to evaluate healing of overlapped drug-eluting stents (DES) vs. bare metal stents (BMS) (sirolimusSES: paclitaxel PES: zotarolimus ZES: Liberté BMS in a 2: 2: 2: 1 ratio) for de novo coronary artery stenosis. OCT was performed at 6-month follow-up. Bifurcation segments with side branch diameters larger than 1.5mm by angiography were analysed. The cross-sectional image at the bifurcation segment was divided into three regions: opposite to the ostium (OO), adjacent to the ostium (AO), or side-branch ostium (SO). Struts were classified in three categories: uncovered (U), covered (C), or proliferative (P). The incidence of each strut category was compared between regions and stent types. There were 12,656 struts in 61 bifurcation segments (PES: 16, SES: 14, ZES: 23, Liberté BMS: 8) from 46 patients obtained at six months. PES had the highest rate of U in SO region (PES 60.1, SES 17.0, ZES 13.2, BMS 12.3 (%), P<0.0001), whereas SES demonstrated the highest rate of U in OO (PES 3.8, SES 14.0, ZES 1.5, BMS 0.0 (%), P=0.0025). CONCLUSIONS: This study demonstrates a variable pattern of strut coverage in the bifurcation among stent technologies, with a high percentage of PES floating struts remaining uncovered at 6-month follow-up.
Authors: Madhusudhana Gargesha; Ronny Shalev; David Prabhu; Kentaro Tanaka; Andrew M Rollins; Marco Costa; Hiram G Bezerra; David L Wilson Journal: J Med Imaging (Bellingham) Date: 2015-01-02
Authors: Lei Song; Gary S Mintz; Dong Yin; Myong Hwa Yamamoto; Chee Yang Chin; Mitsuaki Matsumura; Khady Fall; Ajay J Kirtane; Manish A Parikh; Jeffrey W Moses; Ziad A Ali; Richard A Shlofmitz; Akiko Maehara Journal: Int J Cardiovasc Imaging Date: 2017-03-09 Impact factor: 2.357
Authors: N S van Ditzhuijzen; A Karanasos; N Bruining; M van den Heuvel; O Sorop; J Ligthart; K Witberg; H M Garcia-Garcia; F Zijlstra; D J Duncker; H M M van Beusekom; E Regar Journal: Int J Cardiovasc Imaging Date: 2014-05-16 Impact factor: 2.357
Authors: Hong Lu; Madhusudhana Gargesha; Zhao Wang; Daniel Chamie; Guilherme F Attizzani; Tomoaki Kanaya; Soumya Ray; Marco A Costa; Andrew M Rollins; Hiram G Bezerra; David L Wilson Journal: Biomed Opt Express Date: 2012-10-15 Impact factor: 3.732