Assessment by Optical Coherence Tomography of Stent Struts Across Side Branch – Comparison of Bare-Metal Stents and Drug-Eluting Stents –

Yong Liu; Toshio Imanishi; Takashi Kubo; Atsushi Tanaka; Hironori Kitabata; Takashi Tanimoto; Yasushi Ino; Hideyuki Ikejima; Hiroto Tsujioka; Kenichi Komukai; Kohei Ishibashi; Manabu Kashiwagi; Yuichi Ozaki; Kumiko Hirata; Masato Mizukoshi; Takashi Akasaka

doi:10.1253/circj.CJ-10-0574

Cardiovascular Intervention

Assessment by Optical Coherence Tomography of Stent Struts Across Side Branch

– Comparison of Bare-Metal Stents and Drug-Eluting Stents –

Yong Liu, Toshio Imanishi, Takashi Kubo, Atsushi Tanaka, Hironori Kitabata, Takashi Tanimoto, Yasushi Ino, Hideyuki Ikejima, Hiroto Tsujioka, Kenichi Komukai, Kohei Ishibashi, Manabu Kashiwagi, Yuichi Ozaki, Kumiko Hirata, Masato Mizukoshi, Takashi Akasaka

Author information

Yong Liu
Department of Cardiovascular Medicine, Wakayama Medical University
Toshio Imanishi
Department of Cardiovascular Medicine, Wakayama Medical University
Takashi Kubo
Department of Cardiovascular Medicine, Wakayama Medical University
Atsushi Tanaka
Department of Cardiovascular Medicine, Wakayama Medical University
Hironori Kitabata
Department of Cardiovascular Medicine, Wakayama Medical University
Takashi Tanimoto
Department of Cardiovascular Medicine, Wakayama Medical University
Yasushi Ino
Department of Cardiovascular Medicine, Wakayama Medical University
Hideyuki Ikejima
Department of Cardiovascular Medicine, Wakayama Medical University
Hiroto Tsujioka
Department of Cardiovascular Medicine, Wakayama Medical University
Kenichi Komukai
Department of Cardiovascular Medicine, Wakayama Medical University
Kohei Ishibashi
Department of Cardiovascular Medicine, Wakayama Medical University
Manabu Kashiwagi
Department of Cardiovascular Medicine, Wakayama Medical University
Yuichi Ozaki
Department of Cardiovascular Medicine, Wakayama Medical University
Kumiko Hirata
Department of Cardiovascular Medicine, Wakayama Medical University
Masato Mizukoshi
Department of Cardiovascular Medicine, Wakayama Medical University
Takashi Akasaka
Department of Cardiovascular Medicine, Wakayama Medical University

Keywords: Bifurcation, Neointima, Optical coherence tomography, Stents

JOURNAL FREE ACCESS

2011 Volume 75 Issue 1 Pages 106-112

DOI https://doi.org/10.1253/circj.CJ-10-0574

View "Advance Publication" version (October 28, 2010).

Details

Abstract

Background: Late stent thrombosis (LST) after drug-eluting stent (DES) implantation is a major clinical problem that has not been fully explained. Incomplete neointimal coverage of stent struts is an important morphometric predictor of LST, which may be associated with impaired healing and the absence of full coverage of struts at branch-point ostia. Optical coherence tomography (OCT) was performed to compare 3 types of stents placed across side branches. Methods and Results: At 9-month follow-up, the neointimal coverage of the struts of 58 stents across a side branch was measured by OCT (bare metal (BMS), n=20; sirolimus-eluting (SES), n=23; paclitaxel-eluting (PES), n=15). According to the diameter ratio of side branch to main vessel, the side branches were classified as either large (ratio >0.33) or small (ratio ≤0.33). BMS had the lowest frequency of uncovered struts (29.4%) and the greatest neointimal thickness on the struts (123±33μm). Neointimal thickness on the struts was less for SES than for PES (72±16 vs. 91±22μm, P=0.009), but there was no difference in the frequency of uncovered struts (66.1% vs. 58.6%, P=0.493). For large side branches, the frequency of uncovered struts was greater than in the small group for SES (87.5% vs. 40.7%, P=0.0002) and PES (83.3% vs. 18.2%; P=0.0013); there was no significant difference for BMS (43.8% vs. 16.7%, P=0.138). Conclusions: Neointimal coverage on struts across a side branch was less frequently observed in DES than in BMS, particularly in large side branches. (Circ J 2011; 75: 106-112)

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