Abstract 14826: Optical Coherence Tomographic Findings in the Lesions After Sirolimus-Eluting Stent Implantation With Peri-stent Contrast Staining
Background: Coronary aneurysm after stent implantation is known as one of the risk factors for stent thrombosis. At follow-up coronary angiography, we sometimes noted abnormal angiographic coronary dilatation, less than 50% of the reference vessel, at the site of sirolimus eluting stent (SES) implantation suggesting contrast staining outside the stent struts. We named this finding per-istent contrast staining (PSS). It was unclear of what PSS consists of. Also, little was known about optical coherence tomography (OCT) findings of the lesion with PSS. This study sought to assess OCT findings of the SES-implanted lesion with PSS.
Methods: Between May 2008 and February 2010, we found 44 restenosis lesions with PSS after SES implantation at follow-up coronary angiography. We observed 20 of the 44 lesions in 20 patients using OCT and assessed the relationship between PSS and OCT findings including multiple interstruts hollow (MIH) and incomplete stent apposition (ISA). PSS is defined as contrast staining outside the stent contour extending to >20% of the stent diameter measured by quantitative coronary angiography. MIH is defined as multiple hollow (the maximum depth >0.5 mm) existing between and outside the well-apposed stent struts.
Results: The patients were 13 men and the mean age was 70.4±10.4 years. Figure shows a lesion with PSS in which we could observe both ISA and MIH with OCT. Among the 20 lesions, MIH was observed in 17 lesions (85%), ISA in 12 lesions (60%), and both MIH and ISA in 10 lesions (50%). There was only one lesion in which we found neither MIH nor ISA but minor dissection.
Conclusion: PSS might be closely associated with two different OCT findings, MIH and ISA, in the lesion after SES implantation.
- © 2011 by American Heart Association, Inc.