BACKGROUND: Late stent thrombosis (LST) after drug-eluting stent (DES) implantation is a major clinical problem that has not been fully explained. Incomplete neointimal coverage of stent struts is an important morphometric predictor of LST, which may be associated with impaired healing and the absence of full coverage of struts at branch-point ostia. Optical coherence tomography (OCT) was performed to compare 3 types of stents placed across side branches. METHODS AND RESULTS: At 9-month follow-up, the neointimal coverage of the struts of 58 stents across a side branch was measured by OCT (bare metal (BMS), n = 20; sirolimus-eluting (SES), n = 23; paclitaxel-eluting (PES), n = 15). According to the diameter ratio of side branch to main vessel, the side branches were classified as either large (ratio > 0.33) or small (ratio ≤ 0.33). BMS had the lowest frequency of uncovered struts (29.4%) and the greatest neointimal thickness on the struts (123 ± 33 µm). Neointimal thickness on the struts was less for SES than for PES (72 ± 16 vs. 91 ± 22 µm, P = 0.009), but there was no difference in the frequency of uncovered struts (66.1% vs. 58.6%, P=0.493). For large side branches, the frequency of uncovered struts was greater than in the small group for SES (87.5% vs. 40.7%, P = 0.0002) and PES (83.3% vs. 18.2%; P = 0.0013); there was no significant difference for BMS (43.8% vs. 16.7%, P = 0.138). CONCLUSIONS: Neointimal coverage on struts across a side branch was less frequently observed in DES than in BMS, particularly in large side branches.
BACKGROUND: Late stent thrombosis (LST) after drug-eluting stent (DES) implantation is a major clinical problem that has not been fully explained. Incomplete neointimal coverage of stent struts is an important morphometric predictor of LST, which may be associated with impaired healing and the absence of full coverage of struts at branch-point ostia. Optical coherence tomography (OCT) was performed to compare 3 types of stents placed across side branches. METHODS AND RESULTS: At 9-month follow-up, the neointimal coverage of the struts of 58 stents across a side branch was measured by OCT (bare metal (BMS), n = 20; sirolimus-eluting (SES), n = 23; paclitaxel-eluting (PES), n = 15). According to the diameter ratio of side branch to main vessel, the side branches were classified as either large (ratio > 0.33) or small (ratio ≤ 0.33). BMS had the lowest frequency of uncovered struts (29.4%) and the greatest neointimal thickness on the struts (123 ± 33 µm). Neointimal thickness on the struts was less for SES than for PES (72 ± 16 vs. 91 ± 22 µm, P = 0.009), but there was no difference in the frequency of uncovered struts (66.1% vs. 58.6%, P=0.493). For large side branches, the frequency of uncovered struts was greater than in the small group for SES (87.5% vs. 40.7%, P = 0.0002) and PES (83.3% vs. 18.2%; P = 0.0013); there was no significant difference for BMS (43.8% vs. 16.7%, P = 0.138). CONCLUSIONS: Neointimal coverage on struts across a side branch was less frequently observed in DES than in BMS, particularly in large side branches.
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
Authors: Tomasz Roleder; Jacek Jąkała; Grzegorz L Kałuża; Łukasz Partyka; Klaudia Proniewska; Elżbieta Pociask; Wojciech Zasada; Wojciech Wojakowski; Zbigniew Gąsior; Dariusz Dudek Journal: Postepy Kardiol Interwencyjnej Date: 2015-06-20 Impact factor: 1.426
Authors: Nataliya V Mushenkova; Volha I Summerhill; Dongwei Zhang; Elena B Romanenko; Andrey V Grechko; Alexander N Orekhov Journal: Int J Mol Sci Date: 2020-04-23 Impact factor: 5.923