RT Journal Article
SR Electronic
T1 Optical coherence tomography assessment of the acute effects of stent implantation on the vessel wall: a systematic quantitative approach
JF Heart
JO Heart
FD BMJ Publishing Group Ltd and British Cardiovascular Society
SP 1913
OP 1919
DO 10.1136/hrt.2009.172072
VO 95
IS 23
A1 Gonzalo, N
A1 Serruys, P W
A1 Okamura, T
A1 Shen, Z J
A1 Onuma, Y
A1 Garcia-Garcia, H M
A1 Sarno, G
A1 Schultz, C
A1 van Geuns, R J
A1 Ligthart, J
A1 Regar, E
YR 2009
UL http://heart.bmj.com/content/95/23/1913.abstract
AB Objective: To observe and characterise vessel injury after stenting using optical coherence tomography (OCT), to propose a systematic OCT classification for periprocedural vessel trauma, to evaluate its frequency in stable versus unstable patients and to assess its clinical impact during the hospitalisation period.Setting: Stenting causes vessel injury.Design and interventions: All consecutive patients in whom OCT was performed after stent implantation were included in the study. Qualitative and quantitative assessment of tissue prolapse, intra-stent dissection and edge dissection were performed.Results: Seventy-three patients (80 vessels) were analysed. Tissue prolapse within the stented segment was visible in 78/80 vessels (97.5%). Median number of tissue prolapse sites was 8 (IQR 4–19), mean (SD) area 1.04 (0.9) mm2. Intra-stent dissection flaps were visible in 69/80 vessels (86.3%) (median number 3 (IQR 1.25–6), maximum flap length 450 (220) μm). Fifty-five out of 80 vessels (68.8%) showed dissection cavities (median number 2 (IQR 0–4.75), maximum depth 340 (170) μm). Edge dissection was visible in 20 vessels (mean (SD) length flap 744 (439) μm). The frequency of tissue prolapse or intra-stent dissection was similar in stable and unstable patients (95.6% vs 100%, p = 0.5 for tissue prolapse; 91.1% vs 82.9%, p = 0.3 for intra-stent dissection). There were no events during the hospitalisation period.Conclusions: OCT allows a detailed visualisation of vessel injury after stent implantation and enables a systematic classification and quantification in vivo. In this study, frequency of tissue prolapse or intra-stent dissections after stenting was high, irrespective of the clinical presentation of the patients, and was not associated with clinical events during hospitalisation.