Abstract 11634: Optical Coherence Tomography Findings Immediately After Single Stent Implantation in De Novo Lesions and Their Clinical Significance
Background: Optical Coherence Tomography (OCT) is being adapted gradually in the catheterization laboratories. Post stent complications such as stent edge dissection, malapposition, and in-stent tissue prolapse are frequently observed with this high resolution imaging modality. The incidence and clinical significance of these findings are unknown.
Aim: The aim of the study is to identify complications immediately after single stent implantation in de novo lesion using OCT and to correlate these findings with clinical outcomes.
Methods: Patients who underwent OCT imaging at the end of stent implantation and had at 6-month clinical follow up were selected from the OCT registry.
Results: A total of 190 stents in 185 patients were analyzed. Stent edge dissection occurred in 28.9% of stents (59 edges: 34 at proximal edge and 25 at distal edge), and average size of the flap was 0.86 × 1.74mm. Incidence of dissection was 5.6% in fibrous plaque, 29.4% in Lipid-rich plaque, and 42.6% in calcified plaque (p<0.001; fibrous vs lipid-rich and calcified). Malapposition was identified in 35.8% of stents, in-stent tissue prolapse in 95.7%. Only 3.7% of dissection and 6.3% of in-stent tissue prolapse were detected on angiogram. At 6 months follow up, 3 patients (1.6%) had target lesion revascularization (TLR). Stent edge dissection, malapposition, in-stent tissue prolapse were not related to TLR.
Conclusions: Post stent complications were frequent on OCT, especially when the underlying plaque type is lipid-rich or calcific. Despite frequent complications clinical event was relatively rare. It is still unclear which stent complications identified OCT affect adverse cardiac event. Larger size and longer follow studies are warranted.
- © 2012 by American Heart Association, Inc.