Abstract 16447: The Extents of Malapposition and Stent Strut Coverage in ST-Elevation Myocardial Infarction Treated with Drug-Eluting Stent; Serial Optical Coherence Tomography Follow-up
Objectives: The aim of this study is to identify the extent of malapposition using optical coherent tomography (OCT) in ST-elevation myocardial infarction (STEMI) treated with drug-eluting stent (DES) by serial OCT examination.
Methods: Total 19 patients diagnosed as STEMI and underwent primary percutaneous coronary intervention (PCI) with DES, sirolimus eluting stent (SES) in 7 patients, paclitaxel eluting stent (PES) in 5 patients and zotarolimus eluting stent in 7 patients, were enrolled. OCT was performed within 72 hours at primary PCI and at 8 months during routine follow-up. The extents of malapposition and stent strut coverage were measured and compared among different DES.
Results: At initial, total 4097 struts in 513 mm single-stent segments were analyzed. In strut analysis by OCT, the incidence of malapposition was 18% and the frequency of malapposition were significantly different (28.5% in SES, 11.5% in PES and 12.2% in ZES, p=0.001). At follow-up, total 4854 struts in 608 mm stent segments were evaluated by OCT. In total, the rates of exposed struts were 7.9% and those of malapposition were 1.1%. Exposed strut rates were significantly different among stents (15.5% in SES, 4.9% in PES and 0.6% in ZES, p=0.013), although malapposition rates were not different (2.1% in SES, 1.3% in PES and 0.05% in ZES).
Conclusions: OCT is a powerful tool in detecting malapposition at initial and follow-up in patients with STEMI performing primary PCI treated with DES. ZES might have nearly complete strut coverage and more data with large studies were warranted.
- © 2010 by American Heart Association, Inc.