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Serial three-dimensional optical coherence tomography assessment of strut coverage and intraluminal structures after drug-eluting stent implantation

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Abstract

Understanding of intraluminal structure and distribution of uncovered struts after drug-eluting stent implantation are limited by only 2-dimensional (2D) optical coherence tomography (OCT) images. We compared tissue coverage with 3-dimensional (3D) OCT and 2D quantitative analyses, and changes in intraluminal structure immediately after (baseline) everolimus-eluting stent (EES) implantation and at follow-up. The 2D analyses of uncovered struts ratio and tissue coverage thickness at a 0.5-mm interval were compared to 3D-OCT images and visually classified for the degree of tissue coverage. The difference in tissue coverage at baseline and follow-up after EES implantation was evaluated with tissue coverage scores (TCS) calculated by the 3D-OCT classification (Grade 0–3). 3D-OCT classifications were negatively correlated with uncovered-to-total struts (r = −0.864, P < 0.001) and positively correlated with tissue coverage thickness (r = 0.905, P < 0.001). Follow-up TCS was greater than baseline TCS (0.2 ± 0.4 vs. 1.4 ± 0.5, P < 0.001). Moreover, changes in intraluminal structures and longitudinal distribution of uncovered struts were assessed. Incomplete stent appositions, in-stent dissections, and thrombi were decreased at follow-up, indicating progressive arterial healing. The distribution of uncovered-to-total struts could be assessed by 3D-OCT, which was related to 2D analysis. Significant correlations between 3D-OCT classifications and quantitative analyses were shown. The classification and visual assessment of intraluminal structures by 3D-OCT were useful in evaluating arterial healing after EES implantation.

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Acknowledgments

This study was partly supported by JSPS KAKENHI Grant Number 23591045.

Conflict of interest

None of the authors has any conflicts of interest to declare in relation to this investigation.

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Authors and Affiliations

  1. Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, Yamaguchi, 755-8505, Japan

    Takao Maeda, Takayuki Okamura, Jutaro Yamada, Tomoko Nao, Hiroki Tateishi, Masayuki Yoshimura, Takamasa Oda, Kohzoh Shiraishi, Tadamitsu Nakashima, Takeshi Nakamura, Toshiro Miura & Masafumi Yano

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  1. Takao Maeda
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  2. Takayuki Okamura
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Correspondence to Takayuki Okamura.

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Maeda, T., Okamura, T., Yamada, J. et al. Serial three-dimensional optical coherence tomography assessment of strut coverage and intraluminal structures after drug-eluting stent implantation. Cardiovasc Interv and Ther 29, 31–39 (2014). https://doi.org/10.1007/s12928-013-0209-5

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  • DOI: https://doi.org/10.1007/s12928-013-0209-5

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