Early and Mid-Term Vascular Responses to Optical Coherence Tomography–Guided Everolimus-Eluting Stent Implantation in Stable Coronary Artery Disease

Shinke, Toshiro; Itoh, Tomonori; Ishida, Masaru; Otake, Hiromasa; Terashita, Daisuke; Fusazaki, Tetsuya; Kikuchi, Tatsuo; Okamura, Takayuki; Morita, Takashi; Hayashi, Takatoshi; Sawada, Takahiro; Yasaka, Yoshinori; Inoue, Tatsuo; Matsuura, Akira; Kawata, Masahito; Kozuki, Amane; Shite, Junya; Kataoka, Toru; Hibi, Kiyoshi; Ishihara, Shozo; Kubo, Takashi; Ino, Yasushi; Sonoda, Shinjo; Furuya, Jungo; Sugaya, Teppei; Shibata, Yoshisato; Kuriyama, Nehiro; Igarashi, Nobuaki; Matsumoto, Daisuke; Hiranuma, Noritoshi; Otsuka, Yoritaka; Morino, Yoshihiro

doi:10.1016/j.cjca.2019.07.633

Cited by 10 publications

(6 citation statements)

References 25 publications

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“…The rates of uncovered struts in DP-EES at one month in patients with chronic coronary syndrome seen in our study were similar to our previous report (5.7% versus 6.4%). 17) In addition to strut thickness, strut width also affects early stent coverage. 27,28) On the abluminal side, a narrower strut (i.e., small contact area) generates a higher pressure on the vessel wall, resulting in deeper penetration of the strut into the vessel wall.…”

Section: Discussionmentioning

confidence: 99%

“…Intrastent thrombus was identified as a mass protruding beyond the stent strut into the lumen with a height "250 μm attached to the stent strut's luminal surface and with an irregular surface signal attenuation. 17) Irregular protrusion was defined as an intrastent tissue protruding beyond the stent strut with an irregular surface and a thickness of "250 μm. The percentages of the length of intrastent thrombus and irregular protrusion were calculated by dividing the sum of the longitudinal distance by the length of the stent.…”

Section: Methodsmentioning

confidence: 99%

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Early Vascular Healing Following Bioresorbable-Polymer Sirolimus-Eluting Stent Placement Compared to That with Durable-Polymer Everolimus-Eluting Stent

et al. 2021

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A recent thinner strut drug-eluting stent might facilitate early strut coverage after its placement. We aimed to investigate early vascular healing responses after the placement of an ultrathin-strut bioresorbable-polymer sirolimus-eluting stent (BP-SES) compared to those with a durable-polymer everolimus-eluting stent (DP-EES) using optical coherence tomography (OCT) imaging.This study included 40 patients with chronic coronary syndrome (CCS) who underwent OCT-guided percutaneous coronary intervention (PCI). Twenty patients each received either BP-SES or DP-EES implantation. OCT was performed immediately after stent placement (baseline) and at 1-month follow-up.At one month, the percentage of uncovered struts reduced significantly in both the BP-SES (80.9 ± 10.3% to 2.9 ± 1.7%; P < 0.001) and DP-EES (81.9 ± 13.0% to 5.7 ± 1.8%; P < 0.001) groups, and the percentage was lower in the BP-SES group than in the DP-EES group (P < 0.001). In the BP-SES group, the percentage of malapposed struts also decreased significantly at 1 month (4.9 ± 3.7% to 2.6 ± 3.0%; P = 0.025), which was comparable to that of the DP-EES group (2.5 ± 2.2%; P = 0.860). The optimal cut-off value of the distance between the strut and vessel surface immediately after the placement to predict resolved malapposed struts was !160 μm for BP-SES and !190 μm for DP-EES.Compared to DP-EES, ultrathin-strut BP-SES demonstrated favorable vascular responses at one month, with a lower rate of uncovered struts and a comparable rate of malapposed struts.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Early Vascular Healing Following Bioresorbable-Polymer Sirolimus-Eluting Stent Placement Compared to That with Durable-Polymer Everolimus-Eluting Stent

et al. 2021

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“…Of these study arms, the results of the MECHANISM-AMI-2 W study and MECHANISM-elective-1M and -3M studies have been reported in detail. 8,9 In this study, we performed prespecified analysis for each of the 3-month follow-up arms and post-hoc comparison analysis between the MECHANISM-AMI-3M and MECHANISM-Elective-3M studies. All patients provided written informed consent prior to being admitted to the study.…”

Section: Methodsmentioning

confidence: 99%

Vascular Response Occurring at 3 Months After Everolimus-Eluting Cobalt–Chromium Stent Implantation in Patients With ST-Segment Elevation Myocardial Infarction vs. Stable Coronary Artery Disease

Ishida

Terashita

Itoh

et al. 2020

Circ J

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occurs within 3 months after DES implantation in AMI patients and that delayed vessel healing at the thrombotic lesion is observed within 30 days after DES implantation. 1,3-6 Thus, rapid progression of vascular healing during the early phase, together with thromboresistance, is the desired outcome of DES for AMI patients.Cobalt-chromium everolimus-eluting stent (CoCr-EES), Stent thrombosis (ST) rarely occurs in patients undergoing 2nd-generation drug-eluting stent (DES) implantation for coronary artery disease (CAD), although it remains a critical complication. 1 Patients with acute myocardial infarction (AMI) especially have a relatively high incidence of ST as compared with stable CAD patients. 2 It has also been demonstrated that ST mainly

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“…We used the following definitions according to previously published methods. [16][17][18][19] (1) plaque rupture: discontinuity of the fibrous cap with cavity formation; (2) plaque erosion: the presence of either a thrombus attached to an intact and visualized plaque, a luminal surface irregularity in the culprit lesion in the absence of a thrombus, or an attenuated underlying plaque without superficial lipid accumulation or calcification immediately proximal or distal to an attached thrombus; (3) calcified nodule: a fibrous cap disruption on a The primary endpoint was incomplete stent apposition measured as the percentage of malapposed struts. The secondary endpoints were the percentage of uncovered struts and the percentage of the reduction in atherothrombotic protrusion burden within the stent.…”

Section: Image Analysis and Definitions And Study Endpointsmentioning

confidence: 99%

Early Vascular Response to Ultrathin Biodegradable Polymer Sirolimus-Eluting Stents for the Treatment of ST-Elevation Myocardial Infarction After Plaque Rupture

et al. 2021

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Recent clinical studies suggest that newer-generation drug-eluting stents that combine ultrathin struts and nanocoating (biodegradable polymer sirolimus-eluting stents, BP-SES) could improve long-term clinical outcomes in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). However, the early vascular response to BP-SES in these patients has not been investigated so far.We examined this response in 20 patients with STEMI caused by plaque rupture using frequency-domain optical coherence tomography (OCT) to understand the underlying mechanisms. Plaque rupture was diagnosed by OCT before PCI with BP-SES implantation was performed. OCT was again performed before the final angiography (post-PCI) and after 2 weeks (2W-OCT).BP-SES placement caused protrusion of atherothrombotic material into the stent lumen and incomplete stent apposition in all patients. After 2 weeks, incomplete stent apposition was significantly reduced (% malapposed struts: post-PCI 4.7 ± 3.3%; 2W-OCT 0.9 ± 1.2%; P < 0.0001), and the percentage of uncovered struts also significantly decreased (% uncovered struts: post-PCI; 69.8 ± 18.3%: 2W-OCT; 29.6 ± 11.0%, P < 0.0001). The maximum protrusion area of the atherothrombotic burden was significantly reduced (post-PCI 1.36 ± 0.70 mm 2 ; 2W-OCT 0.98 ± 0.55 mm 2 ; P = 0.004).This study on the early vascular responses following BP-SES implantation showed rapid resolution of atherothrombotic material and progression of strut apposition and coverage.(UMIN000041324)

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Early and Mid-Term Vascular Responses to Optical Coherence Tomography–Guided Everolimus-Eluting Stent Implantation in Stable Coronary Artery Disease

Cited by 10 publications

References 25 publications

Early Vascular Healing Following Bioresorbable-Polymer Sirolimus-Eluting Stent Placement Compared to That with Durable-Polymer Everolimus-Eluting Stent

Early Vascular Healing Following Bioresorbable-Polymer Sirolimus-Eluting Stent Placement Compared to That with Durable-Polymer Everolimus-Eluting Stent

Vascular Response Occurring at 3 Months After Everolimus-Eluting Cobalt–Chromium Stent Implantation in Patients With ST-Segment Elevation Myocardial Infarction vs. Stable Coronary Artery Disease

Early Vascular Response to Ultrathin Biodegradable Polymer Sirolimus-Eluting Stents for the Treatment of ST-Elevation Myocardial Infarction After Plaque Rupture

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