Abstract 20185: Serial Changes of Neointimal Hyperplasia and Coverage on the Drug Eluting Stent Struts Crossing the Side-branch Vessels Evaluated by Optical Coherence Tomography Imaging.
Background: Even in the era of drug-eluting stents (DES), bifurcation lesions remain as one of the most concern in the field of percutaneous coronary intervention (PCI). When DES implantation is performed to cross over the side-branch vessel (SBV) for the treatment of the bifurcation lesion, the lack of attachment of the stent struts to the vessel wall might not allow the neointimal coverage on the stent struts. The status and serial changes of neointimal hyperplasia (NIH) and coverage on DES struts which are placed across the SBV were not well evaluated.
Purpose: The purpose of this study was to evaluate the serial changes of NIH and neointimal coverage on the DES struts with cross over the SBV using Optical Coherence Tomography (OCT) imaging.
Methods: Thirty three patients who were treated bifurcation lesion with single DES implantation (Sirolimus eluting stent in 21 and, paclitaxel-eluting stent in 12) with cross over the SBV (size > 2.0mm) and serial OCT follow up were enrolled in this study. They were imaged with motorized OCT pull back system (1mm/s) analyzed at 0.3 mm interval. Average first follow up OCT images were obtained at 9 months and second follow up were at 21 months after index PCI. HIN of jailed struts and main vessel (MV) struts were measured, and percentage of neointimal coverage with jailed struts and MV struts were calculated.
Results: However, average NIH of MV strut at the second follow up was similar to that at the first follow up, average NIH of jailed strut at the second follow up was significantly increased compared to that in the first follow up. Furthermore, the percentage of uncovered MV strut at the second follow up was not decreased compared to that at the first follow up, the percentage of uncovered jailed strut at the second follow up was significantly decreased compared to that at the first follow up. (Table1)
Conclusions: In this follow up study, delayed endothelialization of jailed struts was observed at more than 20 months follow up.
- © 2010 by American Heart Association, Inc.