Tsunenari Soeda1, Shiro Uemura1, Seung-Jung Park1, Yangsoo Jang1, Stephen Lee1, Jin-Man Cho1, Soo-Joong Kim1, Rocco Vergallo1, Yoshiyasu Minami1, Daniel S Ong1, Lei Gao1, Hang Lee1, Shaosong Zhang1, Bo Yu2, Yoshihiko Saito1, Ik-Kyung Jang2. 1. From Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA (T.S., R.V., Y.M., D.S.O., L.G., I.-K.J.); First Department of Medicine, Nara Medical University, Kashihara, Japan (T.S., S.U., Y.S.); Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea (S.-J.P.,); Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea (Y.J.); Queen Mary Hospital, Hong Kong University, Hong Kong (S.L.); Division of Cardiology, Kyung Hee University, Seoul, Republic of Korea (J.-M.C., S.-J.K., I.-K.J.); Biostatistics Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA (H.L.,); and Department of Cardiology, 2nd Affiliated Hospital of Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China (S.Z., B.Y.). 2. From Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA (T.S., R.V., Y.M., D.S.O., L.G., I.-K.J.); First Department of Medicine, Nara Medical University, Kashihara, Japan (T.S., S.U., Y.S.); Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea (S.-J.P.,); Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea (Y.J.); Queen Mary Hospital, Hong Kong University, Hong Kong (S.L.); Division of Cardiology, Kyung Hee University, Seoul, Republic of Korea (J.-M.C., S.-J.K., I.-K.J.); Biostatistics Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA (H.L.,); and Department of Cardiology, 2nd Affiliated Hospital of Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China (S.Z., B.Y.). yubodr@163.com.
Abstract
BACKGROUND: Optical coherence tomography (OCT) was recently introduced to optimize percutaneous coronary intervention. However, the exact incidence and significance of poststent OCT findings are unknown. METHODS AND RESULTS: A total of 900 lesions treated with 1001 stents in 786 patients who had postprocedure OCT imaging were analyzed to evaluate the incidence of poststent OCT findings and to identify the OCT predictors for device-oriented clinical end points, including cardiac death, target vessel-related myocardial infarction, target lesion revascularization, and stent thrombosis. Patients were followed up to 1 year. Stent edge dissection was detected in 28.7% of lesions, and incomplete stent apposition was detected in 39.1% of lesions. The incidences of smooth protrusion, disrupted fibrous tissue protrusion, and irregular protrusion were 92.9%, 61.0%, and 53.8%, respectively. Small minimal stent area, defined as a lesion with minimal stent area <5.0 mm(2) in a drug-eluting stent or <5.6 mm(2) in a bare metal stent, was observed in 40.4% of lesions. One-year device-oriented clinical end points occurred in 33 patients (4.5%). Following adjustment, irregular protrusion and small minimal stent area were independent OCT predictors of 1-year device-oriented clinical end points (P=0.003 and P=0.012, respectively). CONCLUSIONS: Abnormal poststent OCT findings were frequent. Irregular protrusion and small minimal stent area were independent predictors of 1-year device-oriented clinical end points, which were primarily driven by target lesion revascularization.
BACKGROUND: Optical coherence tomography (OCT) was recently introduced to optimize percutaneous coronary intervention. However, the exact incidence and significance of poststent OCT findings are unknown. METHODS AND RESULTS: A total of 900 lesions treated with 1001 stents in 786 patients who had postprocedure OCT imaging were analyzed to evaluate the incidence of poststent OCT findings and to identify the OCT predictors for device-oriented clinical end points, including cardiac death, target vessel-related myocardial infarction, target lesion revascularization, and stent thrombosis. Patients were followed up to 1 year. Stent edge dissection was detected in 28.7% of lesions, and incomplete stent apposition was detected in 39.1% of lesions. The incidences of smooth protrusion, disrupted fibrous tissue protrusion, and irregular protrusion were 92.9%, 61.0%, and 53.8%, respectively. Small minimal stent area, defined as a lesion with minimal stent area <5.0 mm(2) in a drug-eluting stent or <5.6 mm(2) in a bare metal stent, was observed in 40.4% of lesions. One-year device-oriented clinical end points occurred in 33 patients (4.5%). Following adjustment, irregular protrusion and small minimal stent area were independent OCT predictors of 1-year device-oriented clinical end points (P=0.003 and P=0.012, respectively). CONCLUSIONS: Abnormal poststent OCT findings were frequent. Irregular protrusion and small minimal stent area were independent predictors of 1-year device-oriented clinical end points, which were primarily driven by target lesion revascularization.
Authors: Daisuke Nakamura; Guilherme F Attizzani; Setsu Nishino; Kentaro Tanaka; Mohamad Soud; Gabriel T Pereira; Milana Leygerman; Anas Fares; Audrey Schnell; Marco A Costa; Andrejs Erglis; Hiram G Bezerra Journal: Int J Cardiovasc Imaging Date: 2017-06-08 Impact factor: 2.357
Authors: Tomasz Roleder; Magdalena Dobrolinska; Elzbieta Pociask; Wojciech Wanha; Grzegorz Smolka; Wojciech Walkowicz; Radoslaw Parma; Mariusz Lebek; Tomasz Bochenek; Przemysław Pietraszewski; Elvin Kedhi; Andrzej Ochala; Zbigniew Gasior; Ziad A Ali; Wojciech Wojakowski Journal: Cardiol J Date: 2018-09-24 Impact factor: 2.737