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Education in Heart
Chronic ischaemic heart disease
Intracoronary Imaging
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  • Published on: 22 November 2017
    Intra coronary imaging to detect mal apposition:Are We Seeing Too Much!

    Title of E-letter: Intra coronary imaging to detect mal apposition: Are We Seeing Too Much!
    Authors Name: Dr Yasir Parviz
    Institution: Columbia University Medical Center
    Intracoronary Imaging Heart 2017; 0: heartjnl-2015-307888v1
    Link to the original paper: http://hwmaint.heart.bmj.com/cgi/content/full/heartjnl-2015-307888v1
    Main Text:

    We would like to congratulate Giavarini A et al on this comprehensive, educational article on intracoronary imaging. [1] Various modalities can be used to understand the mechanism of stent failure, and there is an ongoing debate on detection of stent mal-apposition, and whether this has any clinical impact. Acute stent mal-apposition on its own is not associated with adverse clinical events unless associated with under expansion or having inflow- outflow issues. Acute mal-apposition and its associated clinical events are possibly reduced due to negative remodelling.[2] The clinically events are non-significant may be due to the fact that newer generation of stents and stronger antiplatelets are performing very well. There is limited literature evidence to support that acute mal-apposition is associated with stent thrombosis. [3] Late acquired malaposition in combination with other contributing factors can be associated with stent failure. Most of the available literature looking into the mechanism of stent failure is from...

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    Conflict of Interest:
    None declared.