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The initial extent of malapposition in ST-elevation myocardial infarction treated with drug-eluting stent: the usefulness of optical coherence tomography

Authors
 Ung Kim  ;  Jung-Sun Kim  ;  Jin-Sun Kim  ;  Jung-Myung Lee  ;  Jung-Woo Son  ;  Jaedeok Kim  ;  Young-Guk Ko  ;  Donghoon Choi  ;  Yangsoo Jang 
Citation
 YONSEI MEDICAL JOURNAL, Vol.51(3) : 332-338, 2010 
Journal Title
 YONSEI MEDICAL JOURNAL 
ISSN
 0513-5796 
Issue Date
2010
MeSH
Aged ; Angioplasty, Balloon, Coronary/methods ; Drug-Eluting Stents* ; Female ; Humans ; Male ; Middle Aged ; Myocardial Infarction/pathology ; Myocardial Infarction/therapy* ; Paclitaxel/therapeutic use ; Sirolimus/analogs & derivatives ; Sirolimus/therapeutic use ; Tomography, Optical Coherence/methods*
Keywords
Malapposition ; drug eluting stent ; coherence tomography ; optical ; myocardial infarction
Abstract
PURPOSE: The aim of this study is to identify the extent of initial malapposition using optical coherence tomography (OCT) in ST-elevation myocardial infarctions (STEMI) treated with different types of drug-eluting stents (DES). MATERIALS AND METHODS: Twenty four STEMI patients that underwent primary percutaneous coronary intervention (PCI) were enrolled. The OCT and intravascular ultrasound (IVUS) were performed within 72 hours after the primary PCI. Distances between the endo-luminal surface of the strut reflection and the vessel wall and the extent of malapposition were measured and analyzed. RESULTS: Sirolimus-eluting stents (SES), paclitaxel-eluting stents (PES) and zotarolimus-eluting stents (ZES) were deployed in 7 patients (29%), 7 patients (29%) and 10 patients (42%). In total, 4951 struts in 620 mm single-stent segments were analyzed (1463 struts in SES, 1522 in PES, and 1966 in ZES). In strut analysis by OCT, the incidence of malapposition was 17 % (860/4951) and in stent analysis by IVUS, malapposition rate was 21% (5/24). The malapposition rate of strut level using OCT in 5 patients who had malapposition in IVUS was significantly higher than the 19 of those who had not (32 +/- 5% vs. 12 +/- 6%, p = 0.001). In addition, the frequency of malapposition was also significantly different (28% in SES, 11% in PES, 10% in ZES, p = 0.001). The use of SES was an independent predictor of malapposed struts. CONCLUSION: The incidence of malapposition using OCT was quite prevalent in STEMI after primary PCI with DES implantation and SES has especially higher rates of malapposition compared to other DESs.
Files in This Item:
T201000787.pdf Download
DOI
10.3349/ymj.2010.51.3.332
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Ko, Young Guk(고영국) ORCID logo https://orcid.org/0000-0001-7748-5788
Kim, Jae Deok(김재덕)
Kim, Jung Sun(김중선) ORCID logo https://orcid.org/0000-0003-2263-3274
Kim, Jin Sun(김진선)
Son, Jung Woo(손정우)
Lee, Jung Myung(이정명)
Jang, Yang Soo(장양수) ORCID logo https://orcid.org/0000-0002-2169-3112
Choi, Dong Hoon(최동훈) ORCID logo https://orcid.org/0000-0002-2009-9760
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/100816
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