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Examination of the in vivo mechanisms of late drug-eluting stent thrombosis: findings from optical coherence tomography and intravascular ultrasound imaging. Guagliumi G, Sirbu V, Musumeci G, Gerber R, Biondi-Zoccai G, Ikejima H, et al. Pathological correlates of late drug-eluting stent thrombosis: strut coverage as a marker of endothelialization. 2011 57:390–8.įinn AV, Joner M, Nakazawa G, Kolodgie F, Newell J, John MC, et al. Coronary responses and differential mechanisms of late stent thrombosis attributed to first-generation sirolimus- and paclitaxel-eluting stents. Nakazawa G, Finn AV, Vorpahl M, Ladich ER, Kolodgie FD, Virmani R. Risk of stent thrombosis among bare-metal stents, first-generation drug-eluting stents, and second-generation drug-eluting stents: results from a registry of 18,334 patients. Tada T, Byrne RA, Simunovic I, King LA, Cassese S, Joner M, et al.
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The Author(s) under exclusive licence to Japanese Association of Cardiovascular Intervention and Therapeutics. Malapposition immediately after PCI was negatively associated with sufficient NIC at 1 year even without associations between post-PCI OCT findings and subclinical intrastent thrombus or vulnerable stented segment.Ĭoronary angioscopy Malapposition Optical coherence tomography Thrombus. However, no specific OCT findings immediately after PCI were associated with subclinical intrastent thrombus or vulnerable stented segment. A multivariate analysis demonstrated that malapposed struts were negatively associated with sufficient NIC (odds ratio 0.87 95% CI 0.76-0.99 p = 0.029).
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Sufficient NIC, subclinical intrastent thrombus, and vulnerable stented segment were detected in 85 lesions (51%), 47 lesions (28%), and 54 lesions (32%), respectively. We identified the post-PCI OCT findings associated with these CAS findings. Outcome measures were sufficient neointimal coverage (NIC) defined as stent struts embedded in the neointima, subclinical intrastent thrombus, and vulnerable stented segments defined as those with angioscopic yellow or intensive yellow color 1 year after PCI. We enrolled 168 lesions from 119 patients who underwent OCT-guided PCI using DES and follow-up CAS observation at 1 ± 0.5 year from August 2012 to December 2019. The post-PCI OCT findings that are associated with the CAS 1-year vascular response have not been known. Coronary angioscopy (CAS) can evaluate the vascular response after drug-eluting stent (DES) implantation. Optical coherence tomography (OCT) provides higher resolution intravascular imaging and allows detailed evaluations of stent implantation sites post-percutaneous coronary intervention (PCI).