Serial changes of minimal stent malapposition not detected by intravascular ultrasound: Follow-up optical coherence tomography study

Won Ho Kim, Byoung Kwon Lee, Sahng Lee, Jae Min Shim, Jung Sun Kim, Byoung Keuk Kim, Young Guk Ko, Donghoon Choi, Yangsoo Jang, Myeong Ki Hong

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18 Citations (Scopus)

Abstract

Morphologic changes of small-sized post-stent malapposition have not been sufficiently evaluated. We investigated serial changes of minimal post-stent malapposition with a follow-up optical coherence tomography (OCT) study. Post-stent OCT and intravascular ultrasound (IVUS) and follow-up OCT were performed in 26 patients with minimal post-stent malapposition. Serial changes of number and percent of malapposition struts, and mean extra-stent malapposition area were measured in OCT analysis. Zotarolimus-eluting stent (ZES), sirolimus-eluting stent (SES), and paclitaxel-eluting stent (PES) were deployed in 17, 7 and 2 patients, respectively. Mean durations of the follow-up OCT study were 5.7 ± 3.0 months. The minimal post-stent malapposition cannot be detected by the IVUS, but be visualized with an OCT examination. According to different drug-eluting stents, malapposed stent struts were defined as the struts with detachment from the vessel wall ≥160 μm for SES, ≥130 μm for PES, and ≥110 μm for ZES. The percent of malapposition struts significantly decreased from 12.2 ± 11.0% post-stent to 1.0 ± 2.2% follow-up (P < 0.001). There was a significant decrease in the mean extra-stent malapposition area from 0.35 ± 0.16 mm2 post-stent to 0.04 ± 0.11 mm2 follow-up (P < 0.001). Complete disappearance of stent malapposition was also observed in 22 (85%) patients. In conclusion, minimal stent malapposition which is not detectable by IVUS may disappear or decrease in follow-up OCT evaluation.

Original languageEnglish
Pages (from-to)639-644
Number of pages6
JournalClinical Research in Cardiology
Volume99
Issue number10
DOIs
Publication statusPublished - 2010 Oct
Externally publishedYes

Keywords

  • Optical coherence tomography
  • Stent

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Kim, W. H., Lee, B. K., Lee, S., Shim, J. M., Kim, J. S., Kim, B. K., Ko, Y. G., Choi, D., Jang, Y., & Hong, M. K. (2010). Serial changes of minimal stent malapposition not detected by intravascular ultrasound: Follow-up optical coherence tomography study. Clinical Research in Cardiology, 99(10), 639-644. https://doi.org/10.1007/s00392-010-0163-5