Skip to main content
Erschienen in: The International Journal of Cardiovascular Imaging 2/2017

19.10.2016 | Original Paper

Comparison of vascular responses after different types of second-generation drug-eluting stents implantation detected by optical coherence tomography

verfasst von: Hirofumi Ohtani, Shigeki Kimura, Tomoyo Sugiyama, Keiichi Hishikari, Toru Misawa, Masafumi Mizusawa, Kazuto Hayasaka, Yosuke Yamakami, Keisuke Kojima, Yuichiro Sagawa, Hiroyuki Hikita, Takashi Ashikaga, Atsushi Takahashi, Mitsuaki Isobe

Erschienen in: The International Journal of Cardiovascular Imaging | Ausgabe 2/2017

Einloggen, um Zugang zu erhalten

Abstract

Few studies have directly compared vascular responses to second-generation drug-eluting stents (DESs). We performed optical coherence tomography examinations in 56 consecutive patients with implanted single stent [19 cobalt-chromium everolimus-eluting stents (CoCr-EES), 22 platinum-chromium EES (PtCr-EES), and 15 resolute zotarolimus-eluting stents (R-ZES)] for de novo lesions, and who did not have restenosis at their 9-month follow-up. Neointimal thickness (NIT), stent apposition, and neointimal coverage were assessed in every strut. A neointimal unevenness score [(NUS), maximum NIT/average NIT in the same cross-section] was determined for every 1-mm cross-section (CS). A total of 8350 struts and 1159 CSs were analyzed. The CoCr- and PtCr-EES had significantly fewer malapposed struts compared to the R-ZES (CoCr-EES: 0.19 % vs. PtCr-EES: 0.19 % vs. R-ZES: 0.61 %, p = 0.007). Furthermore, the PtCr-EES had a lower frequency of uncovered struts compared to the others (CoCr-EES: 2.0 % vs. PtCr-EES: 1.4 % vs. R-ZES: 2.3 %, p = 0.047). The NUS correlated with the frequency of uncovered struts (p < 0.001, r = 0.54). The EESs demonstrated more homogenous neointimal growth, as shown in the NUS, compared to the R-ZES [CoCr-EES: 1.66 (1.38–1.97) vs. PtCr-EES: 1.67 (1.41–2.00) vs. R-ZES: 1.94 (1.56–2.28), p < 0.001]. Our results demonstrate that unevenness neointimal growth may relate with strut coverage after second-generation DES implantation. The PtCr-EES had a high frequency of strut coverage with a homogeneous neointima, suggesting fewer risks for stent thrombosis.
Literatur
1.
Zurück zum Zitat Moses JW, Leon MB, Popma JJ, Fitzgerald PJ, Holmes DR, O’Shaughnessy C, Caputo RP, Kereiakes DJ, Williams DO, Teirstein PS, Jaeger JL, Kuntz RE; SIRIUS Investigators (2003) Sirolimus-eluting stents versus standard stents in patients with stenosis in a native coronary artery. N Engl J Med 349:1315–1323CrossRefPubMed Moses JW, Leon MB, Popma JJ, Fitzgerald PJ, Holmes DR, O’Shaughnessy C, Caputo RP, Kereiakes DJ, Williams DO, Teirstein PS, Jaeger JL, Kuntz RE; SIRIUS Investigators (2003) Sirolimus-eluting stents versus standard stents in patients with stenosis in a native coronary artery. N Engl J Med 349:1315–1323CrossRefPubMed
2.
Zurück zum Zitat Joner M, Finn AV, Farb A, Mont EK, Kolodgie FD, Ladich E, Kutys R, Skorija K, Gold HK, Virmani R (2006) Pathology of drug-eluting stents in humans: delayed healing and late thrombotic risk. J Am Coll Cardiol 48:193–202CrossRefPubMed Joner M, Finn AV, Farb A, Mont EK, Kolodgie FD, Ladich E, Kutys R, Skorija K, Gold HK, Virmani R (2006) Pathology of drug-eluting stents in humans: delayed healing and late thrombotic risk. J Am Coll Cardiol 48:193–202CrossRefPubMed
3.
Zurück zum Zitat Tada T, Byrne RA, Simunovic I, King LA, Cassese S, Joner M, Fusaro M, Schneider S, Schulz S, Ibrahim T, Ott I, Massberg S, Laugwitz KL, Kastrati A (2013) Risk of stent thrombosis among bare-metal stents, first-generation drug-eluting stents, and second-generation drug-eluting stents: results from a registry of 18,334 patients. JACC Cardiovasc Interv 6:1267–1274CrossRefPubMed Tada T, Byrne RA, Simunovic I, King LA, Cassese S, Joner M, Fusaro M, Schneider S, Schulz S, Ibrahim T, Ott I, Massberg S, Laugwitz KL, Kastrati A (2013) Risk of stent thrombosis among bare-metal stents, first-generation drug-eluting stents, and second-generation drug-eluting stents: results from a registry of 18,334 patients. JACC Cardiovasc Interv 6:1267–1274CrossRefPubMed
4.
Zurück zum Zitat Otsuka F, Vorpahl M, Nakano M, Foerst J, Newell JB, Sakakura K, Kutys R, Ladich E, Finn AV, Kolodgie FD, Virmani R (2014) Pathology of second-generation everolimus-eluting stents versus first-generation sirolimus- and paclitaxel-eluting stents in humans. Circulation 129:211–223CrossRefPubMed Otsuka F, Vorpahl M, Nakano M, Foerst J, Newell JB, Sakakura K, Kutys R, Ladich E, Finn AV, Kolodgie FD, Virmani R (2014) Pathology of second-generation everolimus-eluting stents versus first-generation sirolimus- and paclitaxel-eluting stents in humans. Circulation 129:211–223CrossRefPubMed
5.
Zurück zum Zitat von Birgelen C, Basalus MW, Tandjung K, van Houwelingen KG, Stoel MG, Louwerenburg JH, Linssen GC, Saïd SA, Kleijne MA, Sen H, Löwik MM, van der Palen J, Verhorst PM, de Man FH (2012) A randomized controlled trial in second-generation zotarolimus-eluting Resolute stents versus everolimus-eluting Xience V stents in real-world patients: the TWENTE trial. J Am Coll Cardiol 59:1350–1361CrossRef von Birgelen C, Basalus MW, Tandjung K, van Houwelingen KG, Stoel MG, Louwerenburg JH, Linssen GC, Saïd SA, Kleijne MA, Sen H, Löwik MM, van der Palen J, Verhorst PM, de Man FH (2012) A randomized controlled trial in second-generation zotarolimus-eluting Resolute stents versus everolimus-eluting Xience V stents in real-world patients: the TWENTE trial. J Am Coll Cardiol 59:1350–1361CrossRef
6.
Zurück zum Zitat Stone GW, Teirstein PS, Meredith IT, Farah B, Dubois CL, Feldman RL, Dens J, Hagiwara N, Allocco DJ, Dawkins KD; PLATINUM Trial Investigators (2011) A prospective, randomized evaluation of a novel everolimus-eluting coronary stent: the PLATINUM (a Prospective, Randomized, Multicenter Trial to Assess an Everolimus-Eluting Coronary Stent System [PROMUS Element] for the Treatment of Up to Two de Novo Coronary Artery Lesions) trial. J Am Coll Cardiol 57:1700–1708CrossRefPubMed Stone GW, Teirstein PS, Meredith IT, Farah B, Dubois CL, Feldman RL, Dens J, Hagiwara N, Allocco DJ, Dawkins KD; PLATINUM Trial Investigators (2011) A prospective, randomized evaluation of a novel everolimus-eluting coronary stent: the PLATINUM (a Prospective, Randomized, Multicenter Trial to Assess an Everolimus-Eluting Coronary Stent System [PROMUS Element] for the Treatment of Up to Two de Novo Coronary Artery Lesions) trial. J Am Coll Cardiol 57:1700–1708CrossRefPubMed
7.
Zurück zum Zitat Yazdani SK, Sheehy A, Nakano M, Nakazawa G, Vorpahl M, Otsuka F, Donn RS, Perkins LE, Simonton CA, Kolodgie FD, Virmani R (2013) Preclinical evaluation of second-generation everolimus- and zotarolimus-eluting coronary stents. J Invasive Cardiol 25:383–930PubMed Yazdani SK, Sheehy A, Nakano M, Nakazawa G, Vorpahl M, Otsuka F, Donn RS, Perkins LE, Simonton CA, Kolodgie FD, Virmani R (2013) Preclinical evaluation of second-generation everolimus- and zotarolimus-eluting coronary stents. J Invasive Cardiol 25:383–930PubMed
8.
Zurück zum Zitat Guagliumi G, Sirbu V, Musumeci G, Gerber R, Biondi-Zoccai G, Ikejima H, Ladich E, Lortkipanidze N, Matiashvili A, Valsecchi O, Virmani R, Stone GW (2012) Examination of the in vivo mechanisms of late drug-eluting stent thrombosis findings from optical coherence tomography and intravascular ultrasound imaging. JACC Cardiovasc Interv 5:12–20CrossRefPubMed Guagliumi G, Sirbu V, Musumeci G, Gerber R, Biondi-Zoccai G, Ikejima H, Ladich E, Lortkipanidze N, Matiashvili A, Valsecchi O, Virmani R, Stone GW (2012) Examination of the in vivo mechanisms of late drug-eluting stent thrombosis findings from optical coherence tomography and intravascular ultrasound imaging. JACC Cardiovasc Interv 5:12–20CrossRefPubMed
9.
Zurück zum Zitat Choi HH, Kim JS, Yoon DH, Hong KS, Kim TH, Kim BK, Ko YG, Choi D, Jang Y, Hong MK (2012) Favorable neointimal coverage in everolimus-eluting stent at 9 months after stent implantation: comparison with sirolimus-eluting stent using optical coherence tomography. Int J Cardiovasc Imaging 28:491–497CrossRefPubMed Choi HH, Kim JS, Yoon DH, Hong KS, Kim TH, Kim BK, Ko YG, Choi D, Jang Y, Hong MK (2012) Favorable neointimal coverage in everolimus-eluting stent at 9 months after stent implantation: comparison with sirolimus-eluting stent using optical coherence tomography. Int J Cardiovasc Imaging 28:491–497CrossRefPubMed
10.
Zurück zum Zitat Guagliumi G, Capodanno D, Ikejima H, Bezerra HG, Sirbu V, Musumeci G, Fiocca L, Lortkipanidze N, Vassileva A, Tahara S, Valsecchi O, Costa MA (2013) Impact of different stent alloys on human vascular response to everolimus-eluting stent: an optical coherence tomography study: the OCTEVEREST. Catheter Cardiovasc Interv 81:510–518CrossRefPubMed Guagliumi G, Capodanno D, Ikejima H, Bezerra HG, Sirbu V, Musumeci G, Fiocca L, Lortkipanidze N, Vassileva A, Tahara S, Valsecchi O, Costa MA (2013) Impact of different stent alloys on human vascular response to everolimus-eluting stent: an optical coherence tomography study: the OCTEVEREST. Catheter Cardiovasc Interv 81:510–518CrossRefPubMed
11.
Zurück zum Zitat Gutiérrez-Chico JL, van Geuns RJ, Regar E, van der Giessen WJ, Kelbæk H, Saunamäki K, Escaned J, Gonzalo N, di Mario C, Borgia F, Nüesch E, García-García HM, Silber S, Windecker S, Serruys PW (2011) Tissue coverage of a hydrophilic polymer-coated zotarolimus-eluting stent vs. a fluoropolymer-coated everolimus-eluting stent at 13-month follow-up: an optical coherence tomography substudy from the RESOLUTE All Comers trial. Eur Heart J 32:2454–2463CrossRefPubMedPubMedCentral Gutiérrez-Chico JL, van Geuns RJ, Regar E, van der Giessen WJ, Kelbæk H, Saunamäki K, Escaned J, Gonzalo N, di Mario C, Borgia F, Nüesch E, García-García HM, Silber S, Windecker S, Serruys PW (2011) Tissue coverage of a hydrophilic polymer-coated zotarolimus-eluting stent vs. a fluoropolymer-coated everolimus-eluting stent at 13-month follow-up: an optical coherence tomography substudy from the RESOLUTE All Comers trial. Eur Heart J 32:2454–2463CrossRefPubMedPubMedCentral
12.
Zurück zum Zitat Kim JS, Kim BK, Jang IK, Shin DH, Ko YG, Choi D, Hong MK, Cho YK, Nam CW, Hur SH, Choi JH, Song YB, Hahn JY, Choi SH, Gwon HC, Jang Y (2012) Comparison of neointimal coverage between zotarolimus-eluting stent and everolimus-eluting stent using Optical Coherence Tomography (COVER OCT). Am Heart J 163:601–607CrossRefPubMed Kim JS, Kim BK, Jang IK, Shin DH, Ko YG, Choi D, Hong MK, Cho YK, Nam CW, Hur SH, Choi JH, Song YB, Hahn JY, Choi SH, Gwon HC, Jang Y (2012) Comparison of neointimal coverage between zotarolimus-eluting stent and everolimus-eluting stent using Optical Coherence Tomography (COVER OCT). Am Heart J 163:601–607CrossRefPubMed
13.
Zurück zum Zitat Otake H, Shite J, Ako J, Shinke T, Tanino Y, Ogasawara D, Sawada T, Miyoshi N, Kato H, Koo BK, Honda Y, Fitzgerald PJ, Hirata K (2009) Local determinants of thrombus formation following sirolimus-eluting stent implantation assessed by optical coherence tomography. JACC Cardiovasc Interv 2:459–466CrossRefPubMed Otake H, Shite J, Ako J, Shinke T, Tanino Y, Ogasawara D, Sawada T, Miyoshi N, Kato H, Koo BK, Honda Y, Fitzgerald PJ, Hirata K (2009) Local determinants of thrombus formation following sirolimus-eluting stent implantation assessed by optical coherence tomography. JACC Cardiovasc Interv 2:459–466CrossRefPubMed
14.
Zurück zum Zitat Won H, Shin DH, Kim BK, Mintz GS, Kim JS, Ko YG, Choi D, Jang Y, Hong MK (2013) Optical coherence tomography derived cut-off value of uncovered stent struts to predict adverse clinical outcomes after drug-eluting stent implantation. Int J Cardiovasc Imaging 29:1255–1263CrossRefPubMed Won H, Shin DH, Kim BK, Mintz GS, Kim JS, Ko YG, Choi D, Jang Y, Hong MK (2013) Optical coherence tomography derived cut-off value of uncovered stent struts to predict adverse clinical outcomes after drug-eluting stent implantation. Int J Cardiovasc Imaging 29:1255–1263CrossRefPubMed
15.
Zurück zum Zitat Cook S, Eshtehardi P, Kalesan B, Räber L, Wenaweser P, Togni M, Moschovitis A, Vogel R, Seiler C, Eberli FR, Lüscher T, Meier B, Jüni P, Windecker S (2012) Impact of incomplete stent apposition on long-term clinical outcome after drug-eluting stent implantation. Eur Heart J 33:1334–1343CrossRefPubMed Cook S, Eshtehardi P, Kalesan B, Räber L, Wenaweser P, Togni M, Moschovitis A, Vogel R, Seiler C, Eberli FR, Lüscher T, Meier B, Jüni P, Windecker S (2012) Impact of incomplete stent apposition on long-term clinical outcome after drug-eluting stent implantation. Eur Heart J 33:1334–1343CrossRefPubMed
16.
Zurück zum Zitat Kuroda M, Otake H, Shinke T, Takaya T, Nakagawa M, Osue T, Taniguchi Y, Iwasaki M, Nishio R, Kinutani H, Konishi A, Hirata KI (2015) The impact of in-stent neoatherosclerosis on long-term clinical outcomes: an observational study from the Kobe University Hospital optical coherence tomography registry. EuroIntervention 11:doi:10.4244/EIJY15M12_05 Kuroda M, Otake H, Shinke T, Takaya T, Nakagawa M, Osue T, Taniguchi Y, Iwasaki M, Nishio R, Kinutani H, Konishi A, Hirata KI (2015) The impact of in-stent neoatherosclerosis on long-term clinical outcomes: an observational study from the Kobe University Hospital optical coherence tomography registry. EuroIntervention 11:doi:10.4244/EIJY15M12_05
17.
Zurück zum Zitat Tanigawa J, Barlis P, Dimopoulos K, Dalby M, Moore P, Di Mario C (2009) The influence of strut thickness and cell design on immediate apposition of drug-eluting stents assessed by optical coherence tomography. Int J Cardiol 134:180–188CrossRefPubMed Tanigawa J, Barlis P, Dimopoulos K, Dalby M, Moore P, Di Mario C (2009) The influence of strut thickness and cell design on immediate apposition of drug-eluting stents assessed by optical coherence tomography. Int J Cardiol 134:180–188CrossRefPubMed
18.
Zurück zum Zitat Kim C, Kim BK, Lee SY, Shin DH, Kim JS, Ko YG, Choi D, Jang Y, Hong MK (2015) Incidence, clinical presentation, and predictors of early neoatherosclerosis after drug-eluting stent implantation. Am Heart J 170:591–597CrossRefPubMed Kim C, Kim BK, Lee SY, Shin DH, Kim JS, Ko YG, Choi D, Jang Y, Hong MK (2015) Incidence, clinical presentation, and predictors of early neoatherosclerosis after drug-eluting stent implantation. Am Heart J 170:591–597CrossRefPubMed
19.
Zurück zum Zitat Ishigami K, Uemura S, Morikawa Y, Soeda T, Okayama S, Nishida T, Takemoto Y, Onoue K, Somekawa S, Takeda Y, Kawata H, Horii M, Saito Y (2009) Long-term follow-up of neointimal coverage of sirolimus-eluting stents-evaluation with optical coherence tomography. Circ J 73:2300–2307CrossRefPubMed Ishigami K, Uemura S, Morikawa Y, Soeda T, Okayama S, Nishida T, Takemoto Y, Onoue K, Somekawa S, Takeda Y, Kawata H, Horii M, Saito Y (2009) Long-term follow-up of neointimal coverage of sirolimus-eluting stents-evaluation with optical coherence tomography. Circ J 73:2300–2307CrossRefPubMed
20.
Zurück zum Zitat Gutiérrez-Chico JL, Räber L, Regar E, Okamura T, di Mario C, van Es GA, Windecker S, Serruys PW (2013) Tissue coverage and neointimal hyperplasia in overlap versus nonoverlap segments of drug-eluting stents 9 to 13 months after implantation: in vivo assessment with optical coherence tomography. Am Heart J 166:83–94CrossRefPubMed Gutiérrez-Chico JL, Räber L, Regar E, Okamura T, di Mario C, van Es GA, Windecker S, Serruys PW (2013) Tissue coverage and neointimal hyperplasia in overlap versus nonoverlap segments of drug-eluting stents 9 to 13 months after implantation: in vivo assessment with optical coherence tomography. Am Heart J 166:83–94CrossRefPubMed
21.
Zurück zum Zitat Kim JS, Fan C, Choi D, Jang IK, Lee JM, Kim TH, Park SM, Paik SI, Ko YG, Hong MK, Jang Y, Chung N (2011) Different patterns of neointimal coverage between acute coronary syndrome and stable angina after various types of drug-eluting stents implantation; 9-month follow-up optical coherence tomography study. Int J Cardiol 146:341–346CrossRefPubMed Kim JS, Fan C, Choi D, Jang IK, Lee JM, Kim TH, Park SM, Paik SI, Ko YG, Hong MK, Jang Y, Chung N (2011) Different patterns of neointimal coverage between acute coronary syndrome and stable angina after various types of drug-eluting stents implantation; 9-month follow-up optical coherence tomography study. Int J Cardiol 146:341–346CrossRefPubMed
22.
Zurück zum Zitat Iwasaki M, Otake H, Shinke T, Nakagawa M, Hariki H, Osue T, Inoue T, Taniguchi Y, Nishio R, Kinutani H, Konishi A, Hiranuma N, Kuroda M, Shite J, Hirata K (2014) Vascular responses in patients with and without diabetes mellitus after everolimus-eluting stent implantation. Circ J 78:2188–2196CrossRefPubMed Iwasaki M, Otake H, Shinke T, Nakagawa M, Hariki H, Osue T, Inoue T, Taniguchi Y, Nishio R, Kinutani H, Konishi A, Hiranuma N, Kuroda M, Shite J, Hirata K (2014) Vascular responses in patients with and without diabetes mellitus after everolimus-eluting stent implantation. Circ J 78:2188–2196CrossRefPubMed
23.
Zurück zum Zitat Hwang CW, Wu D, Edelman ER (2001) Physiological transport forces govern drug distribution for stent-based delivery. Circulation 104:600–605CrossRefPubMed Hwang CW, Wu D, Edelman ER (2001) Physiological transport forces govern drug distribution for stent-based delivery. Circulation 104:600–605CrossRefPubMed
24.
Zurück zum Zitat Menown IB, Noad R, Garcia EJ, Meredith I (2010) The platinum chromium element stent platform: from alloy, to design, to clinical practice. Adv Ther 27:129–411CrossRefPubMed Menown IB, Noad R, Garcia EJ, Meredith I (2010) The platinum chromium element stent platform: from alloy, to design, to clinical practice. Adv Ther 27:129–411CrossRefPubMed
25.
Zurück zum Zitat Kereiakes DJ, Cannon LA, Feldman RL, Popma JJ, Magorien R, Whitbourn R, Dauber IM, Rabinowitz AC, Ball MW, Bertolet B, Kabour A, Foster MC, Wang JC, Underwood P, Dawkins KD (2010) Clinical and angiographic outcomes after treatment of de novo coronary stenoses with a novel platinum chromium thin-strut stent: primary results of the PERSEUS (Prospective Evaluation in a Randomized Trial of the Safety and Efficacy of the Use of the TAXUS Element Paclitaxel-Eluting Coronary Stent System) trial. J Am Coll Cardiol 56:264–271CrossRefPubMed Kereiakes DJ, Cannon LA, Feldman RL, Popma JJ, Magorien R, Whitbourn R, Dauber IM, Rabinowitz AC, Ball MW, Bertolet B, Kabour A, Foster MC, Wang JC, Underwood P, Dawkins KD (2010) Clinical and angiographic outcomes after treatment of de novo coronary stenoses with a novel platinum chromium thin-strut stent: primary results of the PERSEUS (Prospective Evaluation in a Randomized Trial of the Safety and Efficacy of the Use of the TAXUS Element Paclitaxel-Eluting Coronary Stent System) trial. J Am Coll Cardiol 56:264–271CrossRefPubMed
26.
Zurück zum Zitat Eppihimer MJ, Sushkova N, Grimsby JL, Efimova N, Kai W, Larson S, Forsyth B, Huibregtse BA, Dawkins KD, Wilson GJ, Granada JF (2013) Impact of stent surface on thrombogenicity and vascular healing: a comparative analysis of metallic and polymeric surfaces. Circ Cardiovasc Interv 6:370–377CrossRefPubMed Eppihimer MJ, Sushkova N, Grimsby JL, Efimova N, Kai W, Larson S, Forsyth B, Huibregtse BA, Dawkins KD, Wilson GJ, Granada JF (2013) Impact of stent surface on thrombogenicity and vascular healing: a comparative analysis of metallic and polymeric surfaces. Circ Cardiovasc Interv 6:370–377CrossRefPubMed
27.
Zurück zum Zitat Chamié D, Abizaid A, Costa JR Jr, Feres F, Almiro da Silva JF, Mattos LA, Staico R, Costa RA, Abizaid A, Tanajura LF, Sousa AG, Sousa JE (2011) Serial angiographic and intravascular ultrasound evaluation to interrogate the presence of late “catch-up” phenomenon after Cypher® sirolimus-eluting stent implantation. Int J Cardiovasc Imaging 27:867–874CrossRefPubMed Chamié D, Abizaid A, Costa JR Jr, Feres F, Almiro da Silva JF, Mattos LA, Staico R, Costa RA, Abizaid A, Tanajura LF, Sousa AG, Sousa JE (2011) Serial angiographic and intravascular ultrasound evaluation to interrogate the presence of late “catch-up” phenomenon after Cypher® sirolimus-eluting stent implantation. Int J Cardiovasc Imaging 27:867–874CrossRefPubMed
Metadaten
Titel
Comparison of vascular responses after different types of second-generation drug-eluting stents implantation detected by optical coherence tomography
verfasst von
Hirofumi Ohtani
Shigeki Kimura
Tomoyo Sugiyama
Keiichi Hishikari
Toru Misawa
Masafumi Mizusawa
Kazuto Hayasaka
Yosuke Yamakami
Keisuke Kojima
Yuichiro Sagawa
Hiroyuki Hikita
Takashi Ashikaga
Atsushi Takahashi
Mitsuaki Isobe
Publikationsdatum
19.10.2016
Verlag
Springer Netherlands
Erschienen in
The International Journal of Cardiovascular Imaging / Ausgabe 2/2017
Print ISSN: 1569-5794
Elektronische ISSN: 1875-8312
DOI
https://doi.org/10.1007/s10554-016-1001-2

Weitere Artikel der Ausgabe 2/2017

The International Journal of Cardiovascular Imaging 2/2017 Zur Ausgabe

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.