Optical coherence tomography at follow-up after percutaneous coronary intervention: relationship between procedural dissections, stent strut malapposition and stent healing.

AIMS: To analyse the relationship between strut apposition as visualised with optical coherence tomography (OCT) at follow-up and clinical and procedural characteristics at stent implantation, and to examine the relationship between strut apposition and stent healing. METHODS AND
RESULTS: Twenty-eight coronary lesions were evaluated. The lesion morphology before stent implantation was described from the baseline angiogram. Strut apposition at follow-up was divided into: (I) apposed struts, (II) struts overlying side branch ostia, (III) malapposed and (IV) protruding struts. Since malapposed and protruding struts often occurred in the same lesions, these were divided into two groups: lesions without (n=20) and lesions with (n=8) the presence of these struts. The thickness of strut coverage was used as a surrogate for stent healing. We analysed 5,159 struts. Sixteen were malapposed and 216 were protruding. Lesions with malapposed and/or protruding struts at OCT follow-up were more frequently associated with acute coronary syndrome (ACS) and procedure related dissections at stent implantation than lesions without. There was a tendency towards a less pronounced strut coverage over malapposed and protruding struts, as compared to apposed struts.
CONCLUSIONS: ACS and procedural dissections at stent implantation may be related to strut malapposition/protrusion at follow-up, which may influence the degree of strut coverage.