TITLE

Optical coherence tomography assessment of the acute effects of stent implantation on the vessel wall: a systematic quantitative approach

AUTHOR(S)
Gonzalo, N.; Serruys, P. W.; Okamura, T.; Shen, Z. J.; Onuma, Y.; Garcia-Garcia, H. M.; Sarno, G.; Schultz, C.; van Geuns, R. J.; Ligthart, J.; Regar, E.
PUB. DATE
December 2009
SOURCE
Heart;Dec2009, Vol. 95 Issue 23, p9
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Objective: To observe and characterise vessel injury after stenting using optical coherence tomography (OCT), to propose a systematic OCT classification for periprocedural vessel trauma, to evaluate its frequency in stable versus unstable patients and to assess its clinical impact during the hospitalisation period. Setting: Stenting causes vessel injury. Design and interventions: All consecutive patients in whom OCT was performed after stent implantation were included in the study. Qualitative and quantitative assessment of tissue prolapse, intra-stent dissection and edge dissection were performed. Results: Seventy-three patients (80 vessels) were analysed. Tissue prolapse within the stented segment was visible in 78/80 vessels (97.5%). Median number of tissue prolapse sites was 8 (IQR 4-19), mean (SD) area 1.04 (0.9) mm². Intra-stent dissection flaps were visible in 69/80 vessels (86.3%) (median number 3 (IQR 1.25-6), maximum flap length 450 (220) μm). Fifty-five out of 80 vessels (68.8%) showed dissection cavities (median number 2 (IQR 0-4.75), maximum depth 340 (170) μm). Edge dissection was visible in 20 vessels (mean (SD) length flap 744 (439) μm). The frequency of tissue prolapse or intra-stent dissection was similar in stable and unstable patients (95.6% vs 100%, p?=?0.5 for tissue prolapse; 91.1% vs 82.9%, p?=?0.3 for intra-stent dissection). There were no events during the hospitalisation period. Conclusions: OCT allows a detailed visualisation of vessel injury after stent implantation and enables a systematic classification and quantification in vivo. In this study, frequency of tissue prolapse or intra-stent dissections after stenting was high, irrespective of the clinical presentation of the patients, and was not associated with clinical events during hospitalisation.
ACCESSION #
47477710

 

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