Incidence and clinical significance of poststent optical coherence tomography findings: One-year follow-up study from a multicenter registry

Tsunenari Soeda, Shiro Uemura, Seung Jung Park, Yangsoo Jang, Stephen Lee, Jin Man Cho, Soo Joong Kim, Rocco Vergallo, Yoshiyasu Minami, Daniel S. Ong, Lei Gao, Hang Lee, Shaosong Zhang, Bo Yu, Yoshihiko Saito, Ik Kyung Jang

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Abstract

Background: Optical coherence tomography (OCT) was recently introduced to optimize percutaneous coronary intervention. However, the exact incidence and significance of poststent OCT findings are unknown. Methods and Results: A total of 900 lesions treated with 1001 stents in 786 patients who had postprocedure OCT imaging were analyzed to evaluate the incidence of poststent OCT findings and to identify the OCT predictors for device-oriented clinical end points, including cardiac death, target vessel-related myocardial infarction, target lesion revascularization, and stent thrombosis. Patients were followed up to 1 year. Stent edge dissection was detected in 28.7% of lesions, and incomplete stent apposition was detected in 39.1% of lesions. The incidences of smooth protrusion, disrupted fibrous tissue protrusion, and irregular protrusion were 92.9%, 61.0%, and 53.8%, respectively. Small minimal stent area, defined as a lesion with minimal stent area <5.0 mm2 in a drug-eluting stent or <5.6 mm 2 in a bare metal stent, was observed in 40.4% of lesions. One-year device-oriented clinical end points occurred in 33 patients (4.5%). Following adjustment, irregular protrusion and small minimal stent area were independent OCT predictors of 1-year device-oriented clinical end points (P=0.003 and P=0.012, respectively). Conclusions: Abnormal poststent OCT findings were frequent. Irregular protrusion and small minimal stent area were independent predictors of 1-year device-oriented clinical end points, which were primarily driven by target lesion revascularization.

Original languageEnglish
Pages (from-to)1020-1029
Number of pages10
JournalCirculation
Volume132
Issue number11
DOIs
Publication statusPublished - 2015 Sep 15

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Optical Coherence Tomography
Stents
Registries
Incidence
Equipment and Supplies
Drug-Eluting Stents
Percutaneous Coronary Intervention
Dissection
Thrombosis
Metals
Myocardial Infarction

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Soeda, Tsunenari ; Uemura, Shiro ; Park, Seung Jung ; Jang, Yangsoo ; Lee, Stephen ; Cho, Jin Man ; Kim, Soo Joong ; Vergallo, Rocco ; Minami, Yoshiyasu ; Ong, Daniel S. ; Gao, Lei ; Lee, Hang ; Zhang, Shaosong ; Yu, Bo ; Saito, Yoshihiko ; Jang, Ik Kyung. / Incidence and clinical significance of poststent optical coherence tomography findings : One-year follow-up study from a multicenter registry. In: Circulation. 2015 ; Vol. 132, No. 11. pp. 1020-1029.
@article{29236165ff0346a7bccafa656ecf78d9,
title = "Incidence and clinical significance of poststent optical coherence tomography findings: One-year follow-up study from a multicenter registry",
abstract = "Background: Optical coherence tomography (OCT) was recently introduced to optimize percutaneous coronary intervention. However, the exact incidence and significance of poststent OCT findings are unknown. Methods and Results: A total of 900 lesions treated with 1001 stents in 786 patients who had postprocedure OCT imaging were analyzed to evaluate the incidence of poststent OCT findings and to identify the OCT predictors for device-oriented clinical end points, including cardiac death, target vessel-related myocardial infarction, target lesion revascularization, and stent thrombosis. Patients were followed up to 1 year. Stent edge dissection was detected in 28.7{\%} of lesions, and incomplete stent apposition was detected in 39.1{\%} of lesions. The incidences of smooth protrusion, disrupted fibrous tissue protrusion, and irregular protrusion were 92.9{\%}, 61.0{\%}, and 53.8{\%}, respectively. Small minimal stent area, defined as a lesion with minimal stent area <5.0 mm2 in a drug-eluting stent or <5.6 mm 2 in a bare metal stent, was observed in 40.4{\%} of lesions. One-year device-oriented clinical end points occurred in 33 patients (4.5{\%}). Following adjustment, irregular protrusion and small minimal stent area were independent OCT predictors of 1-year device-oriented clinical end points (P=0.003 and P=0.012, respectively). Conclusions: Abnormal poststent OCT findings were frequent. Irregular protrusion and small minimal stent area were independent predictors of 1-year device-oriented clinical end points, which were primarily driven by target lesion revascularization.",
author = "Tsunenari Soeda and Shiro Uemura and Park, {Seung Jung} and Yangsoo Jang and Stephen Lee and Cho, {Jin Man} and Kim, {Soo Joong} and Rocco Vergallo and Yoshiyasu Minami and Ong, {Daniel S.} and Lei Gao and Hang Lee and Shaosong Zhang and Bo Yu and Yoshihiko Saito and Jang, {Ik Kyung}",
year = "2015",
month = "9",
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doi = "10.1161/CIRCULATIONAHA.114.014704",
language = "English",
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Soeda, T, Uemura, S, Park, SJ, Jang, Y, Lee, S, Cho, JM, Kim, SJ, Vergallo, R, Minami, Y, Ong, DS, Gao, L, Lee, H, Zhang, S, Yu, B, Saito, Y & Jang, IK 2015, 'Incidence and clinical significance of poststent optical coherence tomography findings: One-year follow-up study from a multicenter registry', Circulation, vol. 132, no. 11, pp. 1020-1029. https://doi.org/10.1161/CIRCULATIONAHA.114.014704

Incidence and clinical significance of poststent optical coherence tomography findings : One-year follow-up study from a multicenter registry. / Soeda, Tsunenari; Uemura, Shiro; Park, Seung Jung; Jang, Yangsoo; Lee, Stephen; Cho, Jin Man; Kim, Soo Joong; Vergallo, Rocco; Minami, Yoshiyasu; Ong, Daniel S.; Gao, Lei; Lee, Hang; Zhang, Shaosong; Yu, Bo; Saito, Yoshihiko; Jang, Ik Kyung.

In: Circulation, Vol. 132, No. 11, 15.09.2015, p. 1020-1029.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Incidence and clinical significance of poststent optical coherence tomography findings

T2 - One-year follow-up study from a multicenter registry

AU - Soeda, Tsunenari

AU - Uemura, Shiro

AU - Park, Seung Jung

AU - Jang, Yangsoo

AU - Lee, Stephen

AU - Cho, Jin Man

AU - Kim, Soo Joong

AU - Vergallo, Rocco

AU - Minami, Yoshiyasu

AU - Ong, Daniel S.

AU - Gao, Lei

AU - Lee, Hang

AU - Zhang, Shaosong

AU - Yu, Bo

AU - Saito, Yoshihiko

AU - Jang, Ik Kyung

PY - 2015/9/15

Y1 - 2015/9/15

N2 - Background: Optical coherence tomography (OCT) was recently introduced to optimize percutaneous coronary intervention. However, the exact incidence and significance of poststent OCT findings are unknown. Methods and Results: A total of 900 lesions treated with 1001 stents in 786 patients who had postprocedure OCT imaging were analyzed to evaluate the incidence of poststent OCT findings and to identify the OCT predictors for device-oriented clinical end points, including cardiac death, target vessel-related myocardial infarction, target lesion revascularization, and stent thrombosis. Patients were followed up to 1 year. Stent edge dissection was detected in 28.7% of lesions, and incomplete stent apposition was detected in 39.1% of lesions. The incidences of smooth protrusion, disrupted fibrous tissue protrusion, and irregular protrusion were 92.9%, 61.0%, and 53.8%, respectively. Small minimal stent area, defined as a lesion with minimal stent area <5.0 mm2 in a drug-eluting stent or <5.6 mm 2 in a bare metal stent, was observed in 40.4% of lesions. One-year device-oriented clinical end points occurred in 33 patients (4.5%). Following adjustment, irregular protrusion and small minimal stent area were independent OCT predictors of 1-year device-oriented clinical end points (P=0.003 and P=0.012, respectively). Conclusions: Abnormal poststent OCT findings were frequent. Irregular protrusion and small minimal stent area were independent predictors of 1-year device-oriented clinical end points, which were primarily driven by target lesion revascularization.

AB - Background: Optical coherence tomography (OCT) was recently introduced to optimize percutaneous coronary intervention. However, the exact incidence and significance of poststent OCT findings are unknown. Methods and Results: A total of 900 lesions treated with 1001 stents in 786 patients who had postprocedure OCT imaging were analyzed to evaluate the incidence of poststent OCT findings and to identify the OCT predictors for device-oriented clinical end points, including cardiac death, target vessel-related myocardial infarction, target lesion revascularization, and stent thrombosis. Patients were followed up to 1 year. Stent edge dissection was detected in 28.7% of lesions, and incomplete stent apposition was detected in 39.1% of lesions. The incidences of smooth protrusion, disrupted fibrous tissue protrusion, and irregular protrusion were 92.9%, 61.0%, and 53.8%, respectively. Small minimal stent area, defined as a lesion with minimal stent area <5.0 mm2 in a drug-eluting stent or <5.6 mm 2 in a bare metal stent, was observed in 40.4% of lesions. One-year device-oriented clinical end points occurred in 33 patients (4.5%). Following adjustment, irregular protrusion and small minimal stent area were independent OCT predictors of 1-year device-oriented clinical end points (P=0.003 and P=0.012, respectively). Conclusions: Abnormal poststent OCT findings were frequent. Irregular protrusion and small minimal stent area were independent predictors of 1-year device-oriented clinical end points, which were primarily driven by target lesion revascularization.

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U2 - 10.1161/CIRCULATIONAHA.114.014704

DO - 10.1161/CIRCULATIONAHA.114.014704

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JF - Circulation

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