Comparison of serial optical coherence tomography imaging following aggressive stent expansion technique: insight from the MECHANISM study.
Aged
Cardiovascular Agents
/ administration & dosage
Chromium Alloys
Coronary Artery Disease
/ diagnostic imaging
Coronary Vessels
/ diagnostic imaging
Drug-Eluting Stents
Everolimus
/ administration & dosage
Female
Humans
Japan
Male
Middle Aged
Neointima
Percutaneous Coronary Intervention
/ adverse effects
Predictive Value of Tests
Prospective Studies
Prosthesis Design
Time Factors
Tomography, Optical Coherence
Treatment Outcome
Wound Healing
Coronary artery disease
Drug-eluting stent
Optical coherence tomography
Percutaneous coronary intervention
Journal
The international journal of cardiovascular imaging
ISSN: 1875-8312
Titre abrégé: Int J Cardiovasc Imaging
Pays: United States
ID NLM: 100969716
Informations de publication
Date de publication:
Feb 2021
Feb 2021
Historique:
received:
03
08
2020
accepted:
26
09
2020
pubmed:
10
10
2020
medline:
8
6
2021
entrez:
9
10
2020
Statut:
ppublish
Résumé
To compare early vascular healing following cobalt-chromium everolimus-eluting stent (CoCr-EES) implantation between groups with or without aggressive stent expansion in patients treated by CoCr-EES for stable coronary artery disease (CAD). Seventy-one stable CAD lesions underwent CoCr-EES implantation and analysis of serial optical coherence tomography (OCT) images obtained post-procedure and at early-term (1- or 3-month) follow-up. The endpoints of this study were neointimal thickness at the time of 1- or 3-month OCT and presence and healing of stent edge dissection. Aggressive stent expansion was defined as a lesion complying with ILUMIEN III sizing protocol; that is, external elastic lamina (EEL) diameter minus maximum balloon diameter ≤ 0.25 mm. Comparing groups with and without aggressive stent expansion, median neointimal thickness at 1 and 3 months after CoCr-EES implantation was similar (1 month: 0.031 mm vs. 0.041 mm, respectively, p = 0.27; 3 months: 0.036 mm vs. 0.040 mm, respectively, p = 0.84). Regarding stent edge findings, the presence of any stent edge dissection immediately after percutaneous coronary intervention was also similar between the groups (25% vs. 15%, respectively; p = 0.30) and most stent edge dissections resolved completely within 3 months, regardless of location or dissection severity. After 1 year, no clinically driven target lesion revascularization or stent thrombosis was observed in either cohort. Even after aggressive stent expansion, early neointimal proliferation appeared modest with CoCr-EES implantation, and most stent edge dissections had resolved by 3 months. These findings may support the feasibility of EEL-based sizing by pre-stenting OCT.
Identifiants
pubmed: 33034867
doi: 10.1007/s10554-020-02047-5
pii: 10.1007/s10554-020-02047-5
doi:
Substances chimiques
Cardiovascular Agents
0
Chromium Alloys
0
Everolimus
9HW64Q8G6G
Types de publication
Comparative Study
Journal Article
Multicenter Study
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
419-428Subventions
Organisme : CSRD VA
ID : 1
Pays : United States
Organisme : Daiichi-Sankyo
ID : 3
Organisme : Daiichi-Sankyo
ID : 6
Organisme : Daiichi-Sankyo
ID : 8
Organisme : Abbott Japan
ID : 2
Organisme : Abbott Japan
ID : 4
Organisme : Abbott Japan
ID : 5
Organisme : Abbott Japan
ID : 7
Organisme : Abbott Japan
ID : 9
Organisme : CSRD VA
ID : 1
Pays : United States
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