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Incidences, Predictors, and Clinical Outcomes of Acute and Late Stent Malapposition Detected by Optical Coherence Tomography After Drug-Eluting Stent Implantation

Authors
 Eui Im  ;  Byeong-Keuk Kim  ;  Young-Guk Ko  ;  Dong-Ho Shin  ;  Jung-Sun Kim  ;  Donghoon Choi  ;  Yangsoo Jang  ;  Myeong-Ki Hong 
Citation
 CIRCULATION-CARDIOVASCULAR INTERVENTIONS, Vol.7(1) : 88-96, 2014 
Journal Title
 CIRCULATION-CARDIOVASCULAR INTERVENTIONS 
ISSN
 1941-7640 
Issue Date
2014
MeSH
Aged ; Aged, 80 and over ; Biomarkers/metabolism ; Coronary Artery Disease/diagnosis* ; Coronary Artery Disease/surgery ; Drug-Eluting Stents/utilization* ; Female ; Follow-Up Studies ; Humans ; Incidence ; Male ; Middle Aged ; Prognosis ; Prosthesis Failure/etiology ; Prosthesis Implantation* ; Tomography, Optical Coherence* ; Treatment Outcome ; Vascular Calcification
Keywords
coronary disease ; drug-eluting stents ; tomography, optical coherence
Abstract
BACKGROUND: We investigated the incidences, predictors, and clinical outcomes of acute and late stent malapposition detected by optical coherence tomography (OCT) after drug-eluting stent implantation. METHODS AND RESULTS: We analyzed the OCT images from 351 patients with 356 lesions who received poststent and follow-up OCT examinations. Acute stent malapposition was observed in 62% of lesions. Approximately half of the acute stent malappositions were located within the edges of the stents. Severe diameter stenosis, calcified lesions, and long stents were independent predictors of acute stent malapposition. Follow-up OCT examinations were performed 175±60 days after drug-eluting stent implantation. Thirty-one percent of lesions with acute stent malapposition remained malapposed (late-persistent stent malapposition) and were typically (72%) located within the edges of the stent. The location within the stent edges and the volume of acute stent malapposition were independent predictors of late-persistent stent malapposition. Acute stent malapposition with a volume >2.56 mm(3) differentiated late-persistent stent malapposition from resolved acute stent malapposition. Late-acquired stent malapposition was detected in 15% of all lesions and was usually (61%) located within the stent body. Late-acquired stent malapposition was more frequently associated with plaque/thrombus prolapse on poststent OCT images (70% versus 42%; P<0.001). Clinical events, including cardiovascular death, nonfatal myocardial infarction, and stent thrombosis, did not occur in patients with late stent malapposition during the follow-up period of 28.6±10.3 months after drug-eluting stent implantation. CONCLUSIONS: Acute, late-persistent, and late-acquired stent malapposition had relatively high incidences but different predictors. The clinical outcome of stent malapposition was favorable.
Full Text
http://circinterventions.ahajournals.org/content/7/1/88.long
DOI
10.1161/CIRCINTERVENTIONS.113.000797
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, 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
Shin, Dong Ho(신동호) ORCID logo https://orcid.org/0000-0002-7874-5542
Im, Eui(임의) ORCID logo https://orcid.org/0000-0002-5333-7593
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/22282913/98148
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