Delayed neointimal coverage on incompletely apposed and side branch struts noted by coherence tomography

Delayed neointimal coverage on incompletely apposed and side branch struts noted by coherence tomography

Delayed neointimal coverage on incompletely apposed stent struts: Delayed stent thrombosis is a nightmare of interventional cardiologists in the era of drug eluting stents. It can occur even long years after stent implantation, especially during withdrawal of anti platelet agent for a needed surgical procedure. Pathological studies have shown that incomplete neointimal coverage as a substrate for very late stent thrombosis. Intravascular ultrasound studies have shown the link between incomplete stent apposition and stent thrombosis. Juan Luis Gutiérrez-Chico 1, Evelyn Regar, Eveline Nüesch, Takayuki Okamura, Joanna Wykrzykowska, Carlo di Mario, Stephan Windecker, Gerrit-Anne van Es, Pierre Gobbens, Peter Jüni and Patrick W Serruys [1] have tried to find out the link between delayed stent thrombosis and incomplete stent thrombosis by in vivo optical coherence tomographic studies. Their study sample included 38 sirolimus-eluting, 33 biolimus-eluting, 57 everolimus-eluting, and 50 zotarolimus-eluting stents in ninety nine patients, with a total of over thirty four thousand stent struts. The risk ratio of delayed neointimal coverage was found to be 9 for nonapposed side branch struts and 9.1 for incomplete stent apposition, compared with well apposed stent struts.

Reference

1. Juan Luis Gutiérrez-Chico, Evelyn Regar, Eveline Nüesch, Takayuki Okamura, Joanna Wykrzykowska, Carlo di Mario, Stephan Windecker, Gerrit-Anne van Es, Pierre Gobbens, Peter Jüni, Patrick W Serruys. Delayed Coverage in Malapposed and Side-Branch Struts With Respect to Well-Apposed Struts in Drug-Eluting Stents: In Vivo Assessment With Optical Coherence Tomography. Circulation. 2011 Aug 2;124(5):612-23.