Morphologic characteristics of late stent malapposition after drug-eluting stents implantation by optical coherence tomography follow-up / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Late stent malapposition was frequently observed after DES implantation, which has been associated with the occurrence of late stent thrombosis due to poor neointimal coverage. This study was designed to evaluate the frequency of late stent malapposition at least 1 year after different DESs implantation by optical coherence tomography (OCT).</p><p><b>METHODS</b>Angiographic and OCT examinations were given to 68 patients who had received total 126 various DESs implantation for at least 1 year to detect late stent malapposition. Malapposed strut distance (MSD), malapposed strut area (MSA), reference lumen area (RLA) and reference stent area (RSA) were checked with off-line OCT analysis.</p><p><b>RESULTS</b>Totally 26 Cypher Select stents, 15 Taxus Liberte stents, 51 Partner stents and 34 Firebird I stents were examined. Among 68 patients who underwent DES implantation, 7 patients (10.3%) had late malapposition. Average RSA, MSA and MSD were (7.9 +/- 2.8) mm(2),(2.0 +/- 1.6) mm(2) and (590 +/- 270) microm respectively. According to the MSA/RSA ratio, 4 patients had slight malapposition, 2 patients had moderate malapposition and 1 patient had severe malapposition.</p><p><b>CONCLUSIONS</b>Late stent malapposition is detected frequently after implantation of DES, but if this predisposes to late stent thrombosis and requires any specific therapy needs to be further elucidated.</p>

Combined use of optical coherence tomography and intravascular ultrasound during percutaneous coronary intervention in patients with coronary artery disease / 中华心血管病杂志

<p><b>OBJECTIVE</b>To evaluate the value of combined optical coherence tomography (OCT) and intravascular ultrasound (IVUS) examinations in detecting coronary artery plaque during percutaneous transluminal coronary intervention (PCI).</p><p><b>METHODS</b>OCT and IVUS examinations were performed on 30 diseased coronary vessels from 27 patients underwent PCI from Feb. 2008 to July. 2008.</p><p><b>RESULTS</b>Seventeen vulnerable plaques (4 intima tearing which were not detected by IVUS), 5 plaque rupture (1 out of 5 was detected by IVUS), 5 thrombus lesions (1 out of 5 was found by IVUS), 12 thin-cap lipid-rich lesions (2 detected by IVUS) were detected by OCT in 22 lesions (without 8 lesions post DES stents). Analysis result of plaque burden by IVUS was superior to that obtained by OCT. In 8 DES stents (implanted for 6 months to 4 years), OCT detected 2 had severe restenosis, 6 stents struts were completely covered with neointima without restenosis, 1 stent had aneurysm-like dilatation. IVUS results were similar except for limitations on exactly detecting neointima post stenting. In 19 newly implanted stents, the incidence of stent under-expansion detected by OCT was 26.0% (same as that by IVUS), stent malposition was 63.2% (10.5% by IVUS, P < 0.01), near stent tearing was 10.5% (not detected by IVUS), tissue prolapse between coronary stent struts was 52.6% (10.5% in IVUS, P < 0.05).</p><p><b>CONCLUSIONS</b>OCT imaging is superior to IVUS on detecting vulnerable plaques and change of structure around stents while IVUS is superior to OCT on estimating plaque burden in patients underwent PCI.</p>