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Heart and Vessels

, Volume 31, Issue 8, pp 1247–1256 | Cite as

Optical coherence tomography analysis of the stent strut and prediction of resolved strut malapposition at 3 months after 2nd-generation drug-eluting stent implantation

  • Daisuke IzumiEmail author
  • Masatoshi Miyahara
  • Naoki Fujimoto
  • Shusuke Fukuoka
  • Masataka Sakai
  • Kaoru Dohi
  • Masaaki Ito
Original Article

Abstract

Our objective was to clarify whether thrombogenic problems with stent struts are resolved at 3 months after 2nd-generation drug-eluting stent implantation. Twenty-one patients with stable angina pectoris having 28 (22 zotarolimus-eluting, 6 everolimus-eluting) stents with optical coherence tomography (OCT)-guided percutaneous coronary intervention (PCI) were evaluated. Stent strut coverage and malapposition were evaluated by OCT immediately after PCI and at 3-month follow-up. Acute strut malapposition was observed in 26 out of 28 analyzed stents (92.9 %). At 3-month follow-up, 7 (26.9 %) of those 26 stents with strut malapposition were completely resolved, and the mean percentages of uncovered struts and malapposed struts were 8.3 and 2.0 % when analyzed by each individual stent. When analyzing a total of 30,060 struts, 807 struts (2.7 %) demonstrated acute strut malapposition. Among these, 219 struts (27.1 %) demonstrated persistent strut malapposition. On the basis of receiver-operating characteristic curve analysis, a strut-to-vessel (S-V) distance ≤160 µm on post-stenting OCT images was the corresponding cutoff point for resolved malapposed struts (sensitivity 78.1 %, specificity 62.8 %, area under the curve 0.758). The S-V distance of persistent malapposed struts on post-stenting OCT images was longer than that of resolved malapposed struts (235 ± 112 vs. 176 ± 93 µm, p < 0.01). At 3 months after PCI, the prevalence rates of uncovered and malapposed struts were relatively low in 2nd-generation drug-eluting stent. Our results suggest that OCT-guide PCI with an S-V distance ≤160 µm may be recommended especially in patients with planed short-term DAPT.

Keywords

Strut malapposition Optical coherence tomography Drug-eluting stents 

Notes

Compliance with ethical standards

Conflict of interest

All authors declare that they have no potential conflict of interest.

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Copyright information

© Springer Japan 2015

Authors and Affiliations

  • Daisuke Izumi
    • 1
    Email author
  • Masatoshi Miyahara
    • 2
  • Naoki Fujimoto
    • 3
  • Shusuke Fukuoka
    • 2
  • Masataka Sakai
    • 2
  • Kaoru Dohi
    • 4
  • Masaaki Ito
    • 4
  1. 1.Department of CardiologyJapanese Red Cross Ise HospitalIse-CityJapan
  2. 2.Department of CardiologyMatsusaka Central General HospitalMatsusakaJapan
  3. 3.Department of Molecular and Laboratory MedicineMie University Graduate School of MedicineTsuJapan
  4. 4.Department of Cardiology and NephrologyMie University Graduate School of MedicineTsuJapan

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