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Serial changes of minimal stent malapposition not detected by intravascular ultrasound: follow-up optical coherence tomography study

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Abstract

Morphologic changes of small-sized post-stent malapposition have not been sufficiently evaluated. We investigated serial changes of minimal post-stent malapposition with a follow-up optical coherence tomography (OCT) study. Post-stent OCT and intravascular ultrasound (IVUS) and follow-up OCT were performed in 26 patients with minimal post-stent malapposition. Serial changes of number and percent of malapposition struts, and mean extra-stent malapposition area were measured in OCT analysis. Zotarolimus-eluting stent (ZES), sirolimus-eluting stent (SES), and paclitaxel-eluting stent (PES) were deployed in 17, 7 and 2 patients, respectively. Mean durations of the follow-up OCT study were 5.7 ± 3.0 months. The minimal post-stent malapposition cannot be detected by the IVUS, but be visualized with an OCT examination. According to different drug-eluting stents, malapposed stent struts were defined as the struts with detachment from the vessel wall ≥160 μm for SES, ≥130 μm for PES, and ≥110 μm for ZES. The percent of malapposition struts significantly decreased from 12.2 ± 11.0% post-stent to 1.0 ± 2.2% follow-up (P < 0.001). There was a significant decrease in the mean extra-stent malapposition area from 0.35 ± 0.16 mm2 post-stent to 0.04 ± 0.11 mm2 follow-up (P < 0.001). Complete disappearance of stent malapposition was also observed in 22 (85%) patients. In conclusion, minimal stent malapposition which is not detectable by IVUS may disappear or decrease in follow-up OCT evaluation.

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Acknowledgments

This study was partly supported by a grant of the Korea Healthcare technology R&D Project, Ministry for Health, Welfare and Family Affairs, Republic of Korea (No. A085012 and A000385), a grant of the Korea Health 21 R&D Project, Ministry of Health & Welfare, Republic of Korea (No. A085136), and the Cardiovascular Research Center, Seoul, Korea.

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Authors and Affiliations

  1. Division of Cardiology, Eulji University Hospital, Eulji University College of Medicine, Daejeon, Korea

    Won Ho Kim & Sahng Lee

  2. Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea

    Byoung Kwon Lee

  3. Division of Cardiology, Yonsei Cardiovascular Center, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, Seoul, 120-752, Korea

    Jae-Min Shim, Jung-Sun Kim, Byoung-Keuk Kim, Young-Guk Ko, Donghoon Choi, Yangsoo Jang & Myeong-Ki Hong

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  1. Won Ho Kim
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  3. Sahng Lee
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Correspondence to Myeong-Ki Hong.

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W. H. Kim and B. K. Lee contributed equally to this work.

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Kim, W.H., Lee, B.K., Lee, S. et al. Serial changes of minimal stent malapposition not detected by intravascular ultrasound: follow-up optical coherence tomography study. Clin Res Cardiol 99, 639–644 (2010). https://doi.org/10.1007/s00392-010-0163-5

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  • DOI: https://doi.org/10.1007/s00392-010-0163-5

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