The relationship between post-stent strut apposition and follow-up strut coverage assessed by a contour plot optical coherence tomography analysis

Jung Sun Kim, Jinyong Ha, Byeong Keuk Kim, Dong Ho Shin, Young Guk Ko, Donghoon Choi, Yangsoo Jang, Myeong Ki Hong

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Objectives This study sought to evaluate the relationship between post-stent strut apposition and follow-up strut coverage using contour plot optical coherence tomographic analysis. Background Tracking the fate of interested regions of struts at different time points has not been investigated. Methods Post-intervention and 6-month follow-up optical coherence tomographic evaluations were performed in 82 patients treated with biolimus- (n = 37) or sirolimus-eluting stents (n = 45). Post-stent apposition was classified as embedded, apposed, or malapposed. For volumetric stent evaluation, the post-intervention strut-artery distance and the neointimal thickness at follow-up were measured as a function of the circumferential arc length and longitudinal stent length. Computer-generated contour plots of the strut-artery distance and neointimal thickness were compared. Results The percentages of embedded and malapposed struts after intervention were 1.8% (Interquartile range [IQR]: 0.6% to 6.2%) and 2.3% (IQR: 0.5% to 5.2%), respectively. The percentages of uncovered and malapposed struts at 6 months were 16.0% (IQR: 7.4% to 33.3%) and 0% (IQR: 0% to 0.7%), respectively. The percentage of uncovered struts at 6 months varied significantly with post-stent strut apposition (0% [IQR: 0% to 11.4%] in embedded, 16.3% [IQR: 8.1% to 31.3%] in apposed, and 26.8% [IQR: 0% to 56.3%] in malapposed, p < 0.001 for all pairwise comparisons). In lesions without tissue prolapse, embedded struts were all covered (100% covered struts) compared with those with tissue prolapse (76.8% covered, p < 0.001). Conclusions The optical coherence tomography-guided optimization of stent strut apposition enhances strut coverage at follow-up. This comprehensive method for evaluating strut apposition may provide more useful information to understanding the serial changes in strut coverage. (Neointimal Coverage After Implantation of Biolimus Eluting Stent With Biodegradable Polymer: Optical Coherence Tomographic Assessment According to the Treatment of Dyslipidemia and Hypertension and the Types of Implanted Drug-Eluting Stents; NCT01502904).

Original languageEnglish
Pages (from-to)641-651
Number of pages11
JournalJACC: Cardiovascular Interventions
Volume7
Issue number6
DOIs
Publication statusPublished - 2014 Jun

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Optical Coherence Tomography
Stents
Prolapse
Arteries
Drug-Eluting Stents
Sirolimus
Dyslipidemias
Polymers
Hypertension

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

@article{1f45a1a8282a43d2a05ef86648e702a1,
title = "The relationship between post-stent strut apposition and follow-up strut coverage assessed by a contour plot optical coherence tomography analysis",
abstract = "Objectives This study sought to evaluate the relationship between post-stent strut apposition and follow-up strut coverage using contour plot optical coherence tomographic analysis. Background Tracking the fate of interested regions of struts at different time points has not been investigated. Methods Post-intervention and 6-month follow-up optical coherence tomographic evaluations were performed in 82 patients treated with biolimus- (n = 37) or sirolimus-eluting stents (n = 45). Post-stent apposition was classified as embedded, apposed, or malapposed. For volumetric stent evaluation, the post-intervention strut-artery distance and the neointimal thickness at follow-up were measured as a function of the circumferential arc length and longitudinal stent length. Computer-generated contour plots of the strut-artery distance and neointimal thickness were compared. Results The percentages of embedded and malapposed struts after intervention were 1.8{\%} (Interquartile range [IQR]: 0.6{\%} to 6.2{\%}) and 2.3{\%} (IQR: 0.5{\%} to 5.2{\%}), respectively. The percentages of uncovered and malapposed struts at 6 months were 16.0{\%} (IQR: 7.4{\%} to 33.3{\%}) and 0{\%} (IQR: 0{\%} to 0.7{\%}), respectively. The percentage of uncovered struts at 6 months varied significantly with post-stent strut apposition (0{\%} [IQR: 0{\%} to 11.4{\%}] in embedded, 16.3{\%} [IQR: 8.1{\%} to 31.3{\%}] in apposed, and 26.8{\%} [IQR: 0{\%} to 56.3{\%}] in malapposed, p < 0.001 for all pairwise comparisons). In lesions without tissue prolapse, embedded struts were all covered (100{\%} covered struts) compared with those with tissue prolapse (76.8{\%} covered, p < 0.001). Conclusions The optical coherence tomography-guided optimization of stent strut apposition enhances strut coverage at follow-up. This comprehensive method for evaluating strut apposition may provide more useful information to understanding the serial changes in strut coverage. (Neointimal Coverage After Implantation of Biolimus Eluting Stent With Biodegradable Polymer: Optical Coherence Tomographic Assessment According to the Treatment of Dyslipidemia and Hypertension and the Types of Implanted Drug-Eluting Stents; NCT01502904).",
author = "Kim, {Jung Sun} and Jinyong Ha and Kim, {Byeong Keuk} and Shin, {Dong Ho} and Ko, {Young Guk} and Donghoon Choi and Yangsoo Jang and Hong, {Myeong Ki}",
year = "2014",
month = "6",
doi = "10.1016/j.jcin.2013.12.205",
language = "English",
volume = "7",
pages = "641--651",
journal = "JACC: Cardiovascular Interventions",
issn = "1936-8798",
publisher = "Elsevier Inc.",
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}

The relationship between post-stent strut apposition and follow-up strut coverage assessed by a contour plot optical coherence tomography analysis. / Kim, Jung Sun; Ha, Jinyong; Kim, Byeong Keuk; Shin, Dong Ho; Ko, Young Guk; Choi, Donghoon; Jang, Yangsoo; Hong, Myeong Ki.

In: JACC: Cardiovascular Interventions, Vol. 7, No. 6, 06.2014, p. 641-651.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The relationship between post-stent strut apposition and follow-up strut coverage assessed by a contour plot optical coherence tomography analysis

AU - Kim, Jung Sun

AU - Ha, Jinyong

AU - Kim, Byeong Keuk

AU - Shin, Dong Ho

AU - Ko, Young Guk

AU - Choi, Donghoon

AU - Jang, Yangsoo

AU - Hong, Myeong Ki

PY - 2014/6

Y1 - 2014/6

N2 - Objectives This study sought to evaluate the relationship between post-stent strut apposition and follow-up strut coverage using contour plot optical coherence tomographic analysis. Background Tracking the fate of interested regions of struts at different time points has not been investigated. Methods Post-intervention and 6-month follow-up optical coherence tomographic evaluations were performed in 82 patients treated with biolimus- (n = 37) or sirolimus-eluting stents (n = 45). Post-stent apposition was classified as embedded, apposed, or malapposed. For volumetric stent evaluation, the post-intervention strut-artery distance and the neointimal thickness at follow-up were measured as a function of the circumferential arc length and longitudinal stent length. Computer-generated contour plots of the strut-artery distance and neointimal thickness were compared. Results The percentages of embedded and malapposed struts after intervention were 1.8% (Interquartile range [IQR]: 0.6% to 6.2%) and 2.3% (IQR: 0.5% to 5.2%), respectively. The percentages of uncovered and malapposed struts at 6 months were 16.0% (IQR: 7.4% to 33.3%) and 0% (IQR: 0% to 0.7%), respectively. The percentage of uncovered struts at 6 months varied significantly with post-stent strut apposition (0% [IQR: 0% to 11.4%] in embedded, 16.3% [IQR: 8.1% to 31.3%] in apposed, and 26.8% [IQR: 0% to 56.3%] in malapposed, p < 0.001 for all pairwise comparisons). In lesions without tissue prolapse, embedded struts were all covered (100% covered struts) compared with those with tissue prolapse (76.8% covered, p < 0.001). Conclusions The optical coherence tomography-guided optimization of stent strut apposition enhances strut coverage at follow-up. This comprehensive method for evaluating strut apposition may provide more useful information to understanding the serial changes in strut coverage. (Neointimal Coverage After Implantation of Biolimus Eluting Stent With Biodegradable Polymer: Optical Coherence Tomographic Assessment According to the Treatment of Dyslipidemia and Hypertension and the Types of Implanted Drug-Eluting Stents; NCT01502904).

AB - Objectives This study sought to evaluate the relationship between post-stent strut apposition and follow-up strut coverage using contour plot optical coherence tomographic analysis. Background Tracking the fate of interested regions of struts at different time points has not been investigated. Methods Post-intervention and 6-month follow-up optical coherence tomographic evaluations were performed in 82 patients treated with biolimus- (n = 37) or sirolimus-eluting stents (n = 45). Post-stent apposition was classified as embedded, apposed, or malapposed. For volumetric stent evaluation, the post-intervention strut-artery distance and the neointimal thickness at follow-up were measured as a function of the circumferential arc length and longitudinal stent length. Computer-generated contour plots of the strut-artery distance and neointimal thickness were compared. Results The percentages of embedded and malapposed struts after intervention were 1.8% (Interquartile range [IQR]: 0.6% to 6.2%) and 2.3% (IQR: 0.5% to 5.2%), respectively. The percentages of uncovered and malapposed struts at 6 months were 16.0% (IQR: 7.4% to 33.3%) and 0% (IQR: 0% to 0.7%), respectively. The percentage of uncovered struts at 6 months varied significantly with post-stent strut apposition (0% [IQR: 0% to 11.4%] in embedded, 16.3% [IQR: 8.1% to 31.3%] in apposed, and 26.8% [IQR: 0% to 56.3%] in malapposed, p < 0.001 for all pairwise comparisons). In lesions without tissue prolapse, embedded struts were all covered (100% covered struts) compared with those with tissue prolapse (76.8% covered, p < 0.001). Conclusions The optical coherence tomography-guided optimization of stent strut apposition enhances strut coverage at follow-up. This comprehensive method for evaluating strut apposition may provide more useful information to understanding the serial changes in strut coverage. (Neointimal Coverage After Implantation of Biolimus Eluting Stent With Biodegradable Polymer: Optical Coherence Tomographic Assessment According to the Treatment of Dyslipidemia and Hypertension and the Types of Implanted Drug-Eluting Stents; NCT01502904).

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