Impact of Coronary Plaque Characteristics on Late Stent Malapposition after Drug-Eluting Stent Implantation.
10.3349/ymj.2015.56.6.1538
- Author:
Sung Jin HONG
1
;
Byeong Keuk KIM
;
Dong Ho SHIN
;
Jung Sun KIM
;
Young Guk KO
;
Donghoon CHOI
;
Yangsoo JANG
;
Myeong Ki HONG
Author Information
1. Division of Cardiology, Department of Internal Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea.
- Publication Type:Evaluation Studies ; Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Drug-eluting stent;
intravascular ultrasound;
optical coherence tomography
- MeSH:
Aged;
Coronary Artery Disease/*therapy/ultrasonography;
Coronary Vessels/*ultrasonography;
*Drug-Eluting Stents;
Female;
Humans;
Male;
Middle Aged;
*Prosthesis Failure;
Time Factors;
Tomography, Optical Coherence/*methods;
*Ultrasonography, Interventional
- From:Yonsei Medical Journal
2015;56(6):1538-1544
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: To evaluate the impact of pre-procedural coronary plaque composition assessed by virtual histology intravascular ultrasound (VH-IVUS) on late stent malapposition assessed by optical coherence tomography (OCT) following drug-eluting stent (DES) implantation. MATERIALS AND METHODS: The study population consisted of 121 patients (121 lesions) who underwent both pre-procedural VH-IVUS and follow-up OCT after DES implantation. The association between pre-procedural plaque composition [necrotic core (NC), dense calcium (DC), fibrotic (FT), and fibro-fatty (FF) volumes] assessed by VH-IVUS and late stent malapposition (percent malapposed struts) or strut coverage (percent uncovered struts) assessed by follow-up OCT was evaluated. RESULTS: Pre-procedural absolute total NC, DC, FT, and FF plaque volumes were 22.9+/-19.0, 7.9+/-9.6, 63.8+/-33.8, and 16.5+/-12.4 mm3, respectively. At 6.3+/-3.1 months post-intervention, percent malapposed and uncovered struts were 0.8+/-2.5% and 15.3+/-16.7%, respectively. Pre-procedural absolute total NC and DC plaque volumes were positively correlated with percent malapposed struts (r=0.44, p<0.001 and r=0.45, p<0.001, respectively), while pre-procedural absolute total FT plaque volume was weakly associated with percent malapposed struts (r=0.220, p=0.015). Pre-procedural absolute total DC plaque volume was the only independent predictor of late stent malapposition on multivariate analysis (beta=1.12, p=0.002). There were no significant correlations between pre-intervention plaque composition and percent uncovered struts. CONCLUSION: Pre-procedural plaque composition was associated with late stent malapposition but not strut coverage after DES implantation. Larger pre-procedural absolute total DC plaque volumes were associated with greater late stent malapposition.
