Kunihiro Shimamura1, Takashi Kubo1, Takashi Akasaka2, Ken Kozuma3, Kazuo Kimura4, Masaki Kawamura5, Tetsuya Sumiyoshi6, Yasushi Ino1, Minoru Yoshiyama7, Shinjo Sonoda8, Keiichi Igarashi9, Akiyoshi Miyazawa3, Hiroyasu Uzui10, Yuji Sakanoue11, Toshiro Shinke12, Yoshihiro Morino13, Kengo Tanabe14, Kazushige Kadota15, Takeshi Kimura16. 1. Department of Cardiovascular Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama, 641-8510, Japan. 2. Department of Cardiovascular Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama, 641-8510, Japan akasat@wakayama-med.ac.jp. 3. Division of Cardiology, Teikyo University Hospital, Tokyo, Japan. 4. Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan. 5. Division of Cardiology, Yokkaichi Social Insurance Hospital, Yokkaichi, Japan. 6. Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan. 7. Division of Internal Medicine and Cardiology, Osaka City University Graduate School of Medicine, Osaka, Japan. 8. Division of Cardiology, University of Occupational and Environmental Health Japan, Kitakyushu, Japan. 9. Division of Cardiology, Hokkaido Social Insurance Hospital, Sapporo, Japan. 10. Department of Cardiovascular Medicine, University of Fukui Hospital, Fukui, Japan. 11. Division of Cardiology, Higashisumiyoshi Morimoto Hospital, Osaka, Japan. 12. Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine, Kobe, Japan. 13. Division of Cardiology, Tokai University Hospital, Kanagawa, Japan. 14. Division of Cardiology, Mitsui Memorial Hospital, Tokyo, Japan. 15. Division of Cardiology, Kurashiki Central Hospital, Kurashiki, Japan. 16. Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Abstract
AIM: 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). METHODS AND 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. Published on behalf of the European Society of Cardiology. All rights reserved.
RCT Entities:
AIM: 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). METHODS AND 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. Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: Mirvat Alasnag; Waqar Ahmed; Rasha Al-Bawardy; Owayed Al Shammeri; Sinjini Biswas; Thomas W Johnson Journal: Front Cardiovasc Med Date: 2022-05-13
Authors: Viktor Kočka; Petr Toušek; Martin Kozel; Andrea Buono; Martin Hajšl; Libor Lisa; Tomáš Buděšínský; Martin Malý; Petr Widimský Journal: J Transl Med Date: 2020-01-30 Impact factor: 5.531