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Optical coherence tomography-based evaluation of malapposed strut coverage after drug-eluting stent implantation

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Abstract

Minimal data exist regarding the use of optical coherence tomography (OCT) to evaluate malapposed strut coverage following implantation of drug-eluting stents (DESs). Follow-up OCT examination after DES implantation was performed in 368 patients with 406 lesions at our institute. We assessed the status of malapposed strut coverage that was identified via OCT in 92 (23 %) lesions. An absence of uncovered struts among malapposed struts was defined as completely covered (CC) malapposition; the presence of uncovered struts was defined as incompletely covered (IC) malapposition. Among the 92 lesions with malapposed DES struts, CC malapposition was detected in 47 lesions (51 %). Compared to lesions with IC malapposition (n = 45, 49 %), lesions with CC malapposition showed a significantly lower percentage of uncovered struts among all the struts (14.9 ± 14.5 vs. 4.4 ± 8.5 %, respectively, p < 0.001) and among the other well-apposed struts without malapposition (12.7 ± 12.8 vs. 4.5 ± 8.7 %, respectively, p = 0.001). The degree of malapposed strut coverage was significantly different according to the type of DES; new-generation DESs such as everolimus- or zotarolimus-eluting stents showed a higher incidence of CC malapposition, compared to first-generation DESs such as sirolimus- or paclitaxel-eluting stents (82 vs. 34 %, respectively, p < 0.001). This study showed the complete coverage in about 50 % of the lesions with malapposed DES struts on follow-up OCT. The degree of malapposed DES strut coverage was strongly affected by the type of implanted DESs.

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Acknowledgments

This study was partly supported by grants from the Korea Healthcare Technology R&D Project, Ministry for Health, Welfare & Family Affairs, Republic of Korea (No. A085012 and A102064), the Korea Health 21 R&D Project, Ministry of Health & Welfare, Republic of Korea (No. A085136), and the Cardiovascular Research Center, Seoul, Korea.

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Authors and Affiliations

  1. Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, Seoul, 120-752, Korea

    Byeong-Keuk Kim, Dong-Ho Shin, Jung-Sun Kim, Young-Guk Ko, Donghoon Choi, Yangsoo Jang & Myeong-Ki Hong

  2. Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Korea

    Yangsoo Jang & Myeong-Ki Hong

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  1. Byeong-Keuk Kim
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  2. Dong-Ho Shin
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  3. Jung-Sun Kim
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  4. Young-Guk Ko
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  5. Donghoon Choi
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  6. Yangsoo Jang
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  7. Myeong-Ki Hong
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Correspondence to Myeong-Ki Hong.

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Kim, BK., Shin, DH., Kim, JS. et al. Optical coherence tomography-based evaluation of malapposed strut coverage after drug-eluting stent implantation. Int J Cardiovasc Imaging 28, 1887–1894 (2012). https://doi.org/10.1007/s10554-012-0039-z

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  • DOI: https://doi.org/10.1007/s10554-012-0039-z

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