Mechanical abnormalities associated with first- and second-generation drug-eluting stent thrombosis analyzed by optical coherence tomography in the national PESTO French registry

Application of an enhanced device to transluminal retrieval of malappositioned coronary stents: An experimental study

“…Acute incomplete stent apposition may be left untreated by interventions such as high pressure post‐dilation using a large‐diameter balloon, because acute incomplete stent apposition is resolved by growth of neointimal filling the space between the incomplete stent apposition struts and the vessel wall . However, a recent report demonstrated that malapposition of stent was the leading potential cause of stent thrombosis in both first and second generation DES . Acute incomplete stent apposition is mostly technique‐dependent and can occur after implantation of any type of stent.…”

Empfehlungen zur Anwendung von intravaskulärer Bildgebung (optische Kohärenztomographie)

“…Nach erfolgreicher PCI wurde bei zufriedenstellendem angiographischem Ergebnis in einem beträchtlichen Anteil der Läsionen (27 %) eine inadäquate Implantation in Form einer Malapposition, einer Unterexpansion oder einer Kantendissektion diagnostiziert und erfolgreich behandelt [20]. Gerade suboptimale Implantationsergebnisse nach PCI stellen ein mithilfe der OCT gut zu identifizierendes und prognostisch bedeutendes Ziel dar: Im französischen PESTO-Register (n = 229), in dem bei Patienten mit akuter und später Stentthrombose eine OCT-Bildgebung erfolgte, ließ sich bei 97 % aller Patienten ein morphologisches Korrelat identifizieren [21,22]. Dabei waren v. a. eine bedeutsame StentstrutMalapposition und eine deutliche -Unterexpansion bei akuten thrombotischen Stentverschlüssen zu finden [21].…”

Vascular response and intrastent thrombus in the early phase after drug‐eluting versus bare‐metal stent implantation in patients with ST‐segment elevation myocardial infarction: An observational, single‐center study

“…Although so‐called second‐generation drug‐eluting stents (G2‐DES) have been developed to overcome residual safety concerns from first‐generation drug‐eluting stent (DES), delayed reendothelialization is still considered to be an inevitable safety matter in any type of DES . In particular, the safety of DES in acute and subacute phases in cases of ST‐segment elevation myocardial infarction (STEMI) was debated as a result of the activated thrombogenicity, instability of residual plaque, and higher frequency of suboptimal results in the procedure .…”

“…KEYWORDS acute coronary syndrome, dual antiplatelet therapy, neointimal coverage, optical coherence tomography 1 | INTRODUCTION Although so-called second-generation drug-eluting stents (G2-DES) have been developed to overcome residual safety concerns from firstgeneration drug-eluting stent (DES), [1][2][3][4] delayed reendothelialization is still considered to be an inevitable safety matter in any type of DES. [5][6][7][8][9][10] In particular, the safety of DES in acute and subacute phases in cases of ST-segment elevation myocardial infarction (STEMI) was debated as a result of the activated thrombogenicity, 11,12 instability of residual plaque, 13 and higher frequency of suboptimal results in the procedure. 14,15 However, contrary to expectations, a lower rate of definite stent thrombosis with an everolimus-eluting stent (EES) compared with the bare-metal stent (BMS) was demonstrated in the EXAMINATION (clinical Evaluation of the Xience-V stent in Acute Myocardial INfArc-TION) trial.…”