Abstract 4711: The Prevalence and Determinant Factors of Intracoronary Thrombus Formation After Various Types of Drug-Eluting Stents Implantation: Optical Coherence Tomography Study
Backgrounds: Intracoronary thrombus has been commonly shown after sirolimus eluting stent (SES) implantation in optical coherence tomography (OCT) examination. But, there was no data for other drug eluting stents (DES). Therefore, we investigated the prevalence and relating factors of intracoronary thrombus after various DES implantations using OCT.
Methods: Two hundred twenty six patients [244 stents: 95 SES, 62 paclitaxel eluting (PES) and 87 zotarolimus eluting stent (ZES)] underwent OCT examination at mean 11 months (3– 66 months) after stent implantation. OCT evaluation focused on the thrombus, neointimal coverage and malapposition at each strut. The baseline, angiographic and OCT findings were assessed according to the presence of thrombus.
Results: The intracoronary thrombus was detected in 35 stents [14%, 27 SES (28%), 7 PES (11%) and 1 ZES (1 %)] and was more frequently found in longer stent, smaller stent diameter and stent at bifurcation. The large number of uncovered struts (26±23 vs. 8±17, p<0.001) and malapposed struts (6±14 vs. 2±6, p<0.001) were also related to the presence of thrombus, which were similar in both SES and PES, respectively. In multivariate logistic analysis, longer stent more than 28 mm (odds ratio (OR): 7.31, CI: 1.79 –29.9, p=0.006), stent diameter smaller than 3.0 mm (OR: 4.38, CI: 1.38 –13.97, p=0.01) and ≥8 uncovered struts (OR: 3.29, CI: 1.07–10.17, p=0.04) were independently associated with intracoronary thrombus after controlling age, gender, diabetes, acute coronary syndrome, lesion type, type of stents, overlapping stent, stent at bifurcation, mean neointima thickness, presence of malapposed struts.
Conclusions: longer stent, smaller stent diameter and larger number of uncovered struts were important factors of thrombus formation after 3 DESs implantation. Therefore, the present study suggests that strut coverage with neointima in OCT might be related with thrombus formation after DESs implantation.