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Temporal changes of incomplete stent apposition during early phase after everolimus-eluting stent implantation: serial optical coherence tomography analyses at 2-week and 4-month

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Abstract

The healing process of acute incomplete stent apposition (ISA) in the early phase after stent implantation has not been well understood. We evaluated the temporal changes of ISA during the early phase after everolimus-eluting stent (EES) implantation using serial optical coherence tomography (OCT) analyses. Serial OCT examinations were performed immediately post-stenting and 2-week and 4-month after EES implantation for patients with ST-segment elevation myocardial infarction. At the most proximal cross-section of the implanted stent, the prevalence of ISA and maximum ISA distance were serially evaluated. In 45 patients with ST-segment elevation myocardial infarction, serial OCT analyses at 2-week and 4-month were performed. The prevalence of ISA gradually decreased over time, being 53.3% at baseline, 37.8% at 2-week follow-up, and 11.1% at 4-month follow-up (P < 0.001). The maximum ISA distance also decreased over time (P < 0.001). A receiver-operating curve analysis found that the optimal cut-off values of the baseline ISA distance for predicting persistent ISA at 2-week follow-up and 4-month follow-up were > 140 µm and > 215 µm, respectively. The baseline ISA distance was closely associated with the healing of ISA in the early phase after EES implantation. Maintaining the minimum ISA distance at post-stenting facilitates early phase healing of acute ISA.

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Abbreviations

ISA:

Incomplete stent apposition

OCT:

Optical coherence tomography

EES:

Everolimus-eluting stent

DAPT:

Dual antiplatelet therapy

ROC:

Receiver operating characteristic

HBR:

High-bleeding risk

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Authors and Affiliations

  1. Department of Cardiology, Aichi Medical University, Nagakute, Japan

    Hirokazu Wakabayashi, Hirohiko Ando, Yusuke Nakano, Hiroaki Takashima, Katsuhisa Waseda, Masahiro Shimoda, Hirofumi Ohashi, Akihiro Suzuki, Shinichiro Sakurai & Tetsuya Amano

Authors
  1. Hirokazu Wakabayashi
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  2. Hirohiko Ando
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  3. Yusuke Nakano
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  4. Hiroaki Takashima
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  5. Katsuhisa Waseda
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  6. Masahiro Shimoda
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  7. Hirofumi Ohashi
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  8. Akihiro Suzuki
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  9. Shinichiro Sakurai
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  10. Tetsuya Amano
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by [HW], [MS], [HO], [AS] and [SS]. The first draft of the manuscript was written by [HA] and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Hirohiko Ando.

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Wakabayashi, H., Ando, H., Nakano, Y. et al. Temporal changes of incomplete stent apposition during early phase after everolimus-eluting stent implantation: serial optical coherence tomography analyses at 2-week and 4-month. Int J Cardiovasc Imaging 37, 411–417 (2021). https://doi.org/10.1007/s10554-020-02023-z

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