Abstract 4366: Influence of Strut Width on Neointimal Coverage After Sirolimus-Eluting Stent Implantation Assessed by Optical Coherence Tomography
Background: Sirolimus-eluting stents (SES) have reduced in-stent restenosis, but late stent thrombosis remains as the most major complication. Some reports suggest that optimal neointimal coverage can prevent late stent thrombosis after SES implantation. On the other hand, optical coherence tomography (OCT) can provide detailed imaging of stent-structure after implantation. We aimed to investigate the influence of stent strut width on neointimal coverage of SES using OCT.
Methods: A total of 11patients (20 stents) underwent OCT at 6 to 9-month follow-up after stent implantation. SES is constructed by two type of stent strut width; wide strut is 0.059mm and narrow strut is 0.115mm. Therefore, we divided SES into wide struts and narrow struts. The condition of strut coverage was defined as follows: covered struts which were buried in the intima over its surface, protruding struts which were buried in the intima under its surface and malapposed struts showed were no contact with intima. If the strut was covered one, neointimal thikness was measured.
Results: We evaluated 2979 struts (narrow=1175, wide=1804) in this study. Incidence of covered struts in narrow struts were significantly higher than that in wide struts, whereas incidence of protoruding struts in narrow struts were significantly lower than that in wide struts (Figure⇓). In the covered struts, neointimal thickness of narrow struts (n=966) was significantly higher than that of wide struts (n=1380). (124±104μm vs. 104±88μm, p<0.01)
Conclusion: Stent strut width is one of significant promoters for neointimal coverage. The adequate stent strut width may be a key to reduce late thrombosis after SES implantation.