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Optical coherence tomography findings of very late stent thrombosis after drug-eluting stent implantation.

Authors
 Young-Guk Ko  ;  Dong-Min Kim  ;  Jin Man Cho  ;  So Yeon Choi  ;  Jung Han Yoon  ;  Jung-Sun Kim  ;  Byeong-Keuk Kim  ;  Donghoon Choi  ;  Yangsoo Jang  ;  Myeong-Ki Hong 
Citation
 INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING, Vol.28(4) : 715-723, 2012 
Journal Title
 INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING 
ISSN
 1569-5794 
Issue Date
2012
MeSH
Adult ; Aged ; Angioplasty, Balloon, Coronary/adverse effects ; Angioplasty, Balloon, Coronary/instrumentation* ; Cardiovascular Agents/administration & dosage ; Chi-Square Distribution ; Coronary Angiography ; Coronary Artery Disease/metabolism ; Coronary Artery Disease/pathology ; Coronary Artery Disease/therapy* ; Coronary Thrombosis/etiology ; Coronary Thrombosis/metabolism ; Coronary Thrombosis/pathology* ; Coronary Vessels/metabolism ; Coronary Vessels/pathology* ; Drug-Eluting Stents* ; Everolimus ; Female ; Humans ; Hyperplasia ; Lipid Metabolism ; Male ; Middle Aged ; Neointima/metabolism ; Neointima/pathology* ; Paclitaxel/administration & dosage ; Predictive Value of Tests ; Prosthesis Design ; Republic of Korea ; Risk Assessment ; Risk Factors ; Sirolimus/administration & dosage ; Sirolimus/analogs & derivatives ; Time Factors ; Tomography, Optical Coherence* ; Treatment Outcome
Keywords
Optical coherence tomography ; Stent ; Thrombosis
Abstract
Previous optical coherence tomography (OCT) studies in patients with drug-eluting stents (DESs)-related very late stent thrombosis (VLST) were scarce. Therefore, we investigated OCT findings of VLST after implantation of DESs. Using OCT, we analyzed the status of stent struts and neointimal characteristics in 18 patients who developed VLST after DES implantation. These results were compared to those in 57 patients with neointimal hyperplasia causing >40% diameter stenosis. Lipid-laden neointima was defined as a region with marked signal attenuation and a diffuse border. Four (22.2%) of 18 patients with VLST had ruptured and lipid-laden neointima inside DESs without uncovered or malapposed stent struts. In the remaining 14 patients who developed VLST without neointimal rupture, uncovered and malapposed struts were observed in nine and seven patients, respectively, and lipid-laden neointima in four patients. Lipid-laden neointima was more frequently observed in four patients with neointimal rupture than in 14 patients without neointimal rupture (100% vs. 28.6%, respectively, P = 0.023). Of 57 patients with neointimal hyperplasia, eight (14.0%) had lipid-laden neointima. Time to OCT study after DES implantation was significantly longer in the eight patients with lipid-laden neointima than in 49 patients without lipid-laden neointima (45.5 ± 17.7 months vs. 11.7 ± 7.2 months, respectively, P < 0.001). Lipid-laden neointima was detected in some patients with neointimal hyperplasia > 1 year after DES implantation. In addition to uncovered or malapposed struts, rupture of lipid-laden neointima inside DESs was identified in some patients with DES-related VLST.
Full Text
http://link.springer.com/article/10.1007%2Fs10554-011-9905-3
DOI
21656060
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, Dong Min(김동민)
Kim, Byeong Keuk(김병극) ORCID logo https://orcid.org/0000-0003-2493-066X
Kim, Jung Sun(김중선) ORCID logo https://orcid.org/0000-0003-2263-3274
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
Hong, Myeong Ki(홍명기) ORCID logo https://orcid.org/0000-0002-2090-2031
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/90455
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