Late Incomplete stent apposition is associated with late/very late stent thrombosis: A meta‐analysis

Sethi, Ankur; Singbal, Y.; Rastogi, Ujjwal; Prasad, Vinoy

doi:10.1002/ccd.27102

Cited by 11 publications

(5 citation statements)

References 36 publications

(38 reference statements)

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“…Our recent SBS-related research showed that SBS has not significantly increased the radiation dose of patients in clinical applications [ 15 ] and further confirmed that SBS can effectively identify stent underexpansion in coronary ostial lesions [ 16 ]. More importantly, recent study found that poor stent expansion has a more pronounced effect on the prognosis of patients [ 17 ]. Therefore, in this study, we focused on the analysis of the SBS technology on the recognition effect of stent underexpansion.…”

Section: Discussionmentioning

confidence: 99%

Optical coherence tomography: evaluating the effects of stent boost subtract imaging on stent underexpansion in STEMI patients

Duan

Jing

Pan

et al. 2022

BMC Cardiovasc Disord

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Background To evaluate the effect of stent boost subtract (SBS) imaging on stent underexpansion during percutaneous coronary intervention (PCI) in patients with acute ST-segment elevation myocardial infarction (STEMI) by optical coherence tomography (OCT). Methods One hundred thirty-eight STEMI patients who underwent drug-eluting stent (DES) implantation were prospectively recruited and divided into the SBS group (69 cases) and the CAG group (69 cases) according to whether SBS was used to guide PCI. Finally, OCT was performed on all enrolled patients, and the OCT results were used as the gold standard to evaluate the impact of standard SBS technology on stent underexpansion immediately after DES implantation. Results SBS identified 51 patients (24%) with stent underexpansion while OCT identified 56 patients (27.2%). SBS has a sensitivity of 80%, a specificity of 96%, a positive predictive value of 88%, and a negative predictive value of 93% for identifying stent underexpansion. Conclusion Compared with OCT, SBS technology is a rapid stent imaging evaluation method that can accurately quantify the stent expansion level and is time-saving and economical.

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Section: Discussionmentioning

confidence: 99%

Optical coherence tomography: evaluating the effects of stent boost subtract imaging on stent underexpansion in STEMI patients

Duan

Jing

Pan

et al. 2022

BMC Cardiovasc Disord

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“…These findings highlight the importance of the optimal implantation technique. A meta-analysis (32) techniques make it possible for the pathomechanisms underlying the development of ST to be detected early on and for the relevant countermeasures to be taken (Figure 2). Jang et al (33) showed that IVUS-guided implantation of DES is associated with a significant reduction in overall mortality (OR: 0.64; [0.51; 0.81]; p <0.001), as well as significantly lower rates of MI (OR: 0.57; [0.42; 0.78], p <0.001) and ST (OR: 0.59; [0.42; 0.82]; p = 0.002).…”

Section: Prevention By Using Modern Intracoronary Imaging Techniquesmentioning

confidence: 99%

Coronary Stent Thrombosis — Predictors and Prevention

Ullrich¹,

Münzel²,

Gori³

2020

Deutsches Ärzteblatt International

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“…В ряде случаев это связано с неполным прилеганием стента к стенке артерии -мальпозицией. По результатам метаанализа A. Sethi и соавт., неполная аппозиция стента к стенке артерии ассоциируется с увеличением риска позднего и очень позднего тромбоза стента [8]. C. Bernelli и соавт.…”

Section: Discussionunclassified

Optical coherence tomography assessment of coronary stents 5 years after implantation for ST-elevation myocardial infraction

Бессонов¹,

Кузнецов²,

Dyakova³

et al. 2020

PKiK

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Background. Main causes of very late stent thrombosis are neoatherosclerosis, late malapposition and the presence of uncovered struts. However, it remains unclear how often the above-described pathological changes are determined in stable patients without adverse cardiac events.Aim. In the present study we aimed to perform optical coherence tomography (OCT) assessment of coronary stents 5 years after implantation for ST-elevation myocardial infarction.Methods. Among 194 patients included in the hospital “Prospective PCI Registry” from October 2012 to November 2013, 25 patients were enrolled in the study. All patients received OCT, median time was 66 [63.0; 72.5] months. Only stable patients without adverse cardiac events during follow-up were included in the study. The optimal condition of the coronary stents was determined in the absence of uncovered and malapposed struts, restenosis (more than 50 % of the artery diameter), signs of neoatherosclerosis and thrombus.Results. Based on OCT results, two groups were identified. The first group consisted of 9 patients (36 %) with optimal stent condition. The comparison group included 16 patients with suboptimal condition of the coronary stents. At the same time 13 patients of this group had uncovered struts, 9 — malapposed struts, 8 had both uncovered and malapposed struts, 7 patients had neoatherosclerosis, 3 patients had restenosis of more than 50 % of the vessel diameter, 1 patient — thrombus in the stented segment, 4 patients — coronary evaginations. Uncovered struts were more often found in the proximal and middle segments of the stents, while malapposed struts in the middle segments of the stents. There was direct correlation between the percent of uncovered and malapposed struts (r = 0.544; р = 0.005), percent of uncovered struts and malapposition length (r = 0.601; р = 0.002), percent of uncovered struts and maximum distance of malposition (r = 0.574; р = 0.003). The incidence of neoatherosclerosis was associated with increase in the length stents (odds ratio = 1.15, 95% CI 1.01–1.31, p = 0.039).Conclusion. In most patients, stent condition was suboptimal 5 years after implantation for STEMI. Neoatherosclerosis, malapposition and uncoated struts were the main reasons for suboptimal stent condition.Received 16 September 2020. Revised 9 October 2020. Accepted 12 October 2020.Funding: The study did not have sponsorship.Conflict of interest: Authors declare no conflict of interest.Author contributions Conception and design: I.S. Bessonov Drafting the article: I.S. Bessonov, A.O. Dyakova, A.I. Kostousova, S.S. Sapoznikov, E.A. Gorbatenko Critical revision of the article: V.A. Kuznetsov, E.A. Gorbatenko Final approval of the version to be published: I.S. Bessonov, V.A. Kuznetsov, A.O. Dyakova, A.I. Kostousova, S.S. Sapoznikov, E.A. Gorbatenko

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Late Incomplete stent apposition is associated with late/very late stent thrombosis: A meta‐analysis

Abstract: The presence of LISA at a follow up of 6-18 months after stent implantation is associated with a higher risk of late/very late ST and MI. Additional studies are required to establish a cause and effect, and inform the management strategy. © 2017 Wiley Periodicals, Inc.

Cited by 11 publications

References 36 publications

Optical coherence tomography: evaluating the effects of stent boost subtract imaging on stent underexpansion in STEMI patients

Optical coherence tomography: evaluating the effects of stent boost subtract imaging on stent underexpansion in STEMI patients

Coronary Stent Thrombosis — Predictors and Prevention

Optical coherence tomography assessment of coronary stents 5 years after implantation for ST-elevation myocardial infraction

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