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Chinese Medical Journal, 2010, Vol. 123 No. 5:581-584
Morphologic characteristics of late stent malapposition after drug-eluting stents implantation by optical coherence tomography follow-up
HOU Jing-bo, LIU Hui-min, MA Li-jia, YANG Shuang, MENG Ling-bo, HAN Zhi-gang, ZHANG Shuo, YU Bo
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Keywords: drug-eluting stent·late stent malapposition·very late stent thrombosis·optical coherence tomography
Abstract:

Background  Late stent malapposition was frequently observed after DES implantation, which has been associated with the occurrence of late stent thrombosis due to poor neointimal coverage. This study was designed to evaluate the frequency of late stent malapposition at least 1 year after different DESs implantation by optical coherence tomography (OCT).
Methods  Angiographic and OCT examinations were given to 68 patients who had received total 126 various DESs implantation for at least 1 year to detect late stent malapposition. Malapposed strut distance (MSD), malapposed strut area (MSA), reference lumen area (RLA) and reference stent area (RSA) were checked with off-line OCT analysis.
Results  Totally 26 Cypher Select stents, 15 Taxus Liberte stents, 51 Partner stents and 34 Firebird I stents were examined. Among 68 patients who underwent DES implantation, 7 patients (10.3%) had late malapposition. Average RSA , MSA and MSD were (7.9±2.8) mm2,(2.0±1.6) mm2 and (590±270) µm respectively. According to the MSA/RSA ratio, 4 patients had slight malapposition, 2 patients had moderate malapposition and 1 patient had severe malapposition.
Conclusions
   Late stent malapposition is detected frequently after implantation of DES, but if this predisposes to late stent thrombosis and requires any specific therapy needs to be further elucidated.

Chinese Medical Journal 2010;123(5):581-584
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HOU Jing-bo Department of Cardiology, Second Affiliated Hospital of Harbin Medical University; Key Laboratories of Education Ministry for Myocardial Ischemia Mechanism and Treatment, Harbin, Heilongjiang 150086, China; LIU Hui-min Department of Cardiology, Second Affiliated Hospital of Harbin Medical University; Key Laboratories of Education Ministry for Myocardial Ischemia Mechanism and Treatment, Harbin, Heilongjiang 150086, China; MA Li-jia Department of Cardiology, Second Affiliated Hospital of Harbin Medical University; Key Laboratories of Education Ministry for Myocardial Ischemia Mechanism and Treatment, Harbin, Heilongjiang 150086, China; YANG Shuang Department of Cardiology, Second Affiliated Hospital of Harbin Medical University; Key Laboratories of Education Ministry for Myocardial Ischemia Mechanism and Treatment, Harbin, Heilongjiang 150086, China; MENG Ling-bo Department of Cardiology, Second Affiliated Hospital of Harbin Medical University; Key Laboratories of Education Ministry for Myocardial Ischemia Mechanism and Treatment, Harbin, Heilongjiang 150086, China; HAN Zhi-gang Department of Cardiology, Second Affiliated Hospital of Harbin Medical University; Key Laboratories of Education Ministry for Myocardial Ischemia Mechanism and Treatment, Harbin, Heilongjiang 150086, China; ZHANG Shuo Department of Cardiology, Second Affiliated Hospital of Harbin Medical University; Key Laboratories of Education Ministry for Myocardial Ischemia Mechanism and Treatment, Harbin, Heilongjiang 150086, China; YU Bo Department of Cardiology, Second Affiliated Hospital of Harbin Medical University; Key Laboratories of Education Ministry for Myocardial Ischemia Mechanism and Treatment, Harbin, Heilongjiang 150086, China

Correspondence to: ZHANG Shuo  Department of Cardiology, Second Affiliated Hospital of Harbin Medical University; Key Laboratories of Education Ministry for Myocardial Ischemia Mechanism and Treatment, Harbin, Heilongjiang 150086, China  (Tel:86-451-89804928 Fax:86-451-86605180 Email:zhangshuoemail@163.com )
 
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