Abstract 13271: Incidence of Stent Complications detected by Optical Coherence Tomography and their Clinical Significance: One Year Follow up Study
Introduction: Optical coherence tomography (OCT) was introduced to optimize percutaneous coronary intervention (PCI). Due to its unprecedented resolution, complications are frequently visualized. The exact incidence and clinical significance of these OCT detected complications are unknown.
Object: The aims of this study were 1) to evaluate the incidence of acute stent complications by OCT, 2) to correlate these complications with clinical outcome at 1 year, and 3) to identify the OCT predictors for major adverse cardiac events (MACE) including death, acute myocardial infarction (AMI), stent thrombosis, and target lesion revascularizations (TLR).
Methods and Results: A total of 409 patients with 473 drug eluting stents (DES) who had post stent OCT imaging were included in this study. The incidence of stent edge dissection was 36.4% and of intra stent dissection was 72.3%. Incomplete stent apposition was detected in 36.4% of stents. The incidence of smooth protrusion, fibrous flap or disrupted fibrous plaque, irregular protrusion and thrombus were 93.7%, 56.0%, 55.2%, and 33.4%, respectively. Minimal stent underexpansion defined by minimal stent area (MSA) < 1.0 of reference area and severe stent underexpansion defined by MSA< 0.8 of reference area were observed in 84.8% and 37.8% of stents. MACE occurred in 3.7% of cases at 1 year follow up. There was no death. AMI, stent thrombosis, and TLR occurred in 0.7%, 0.2%, and 3.2%. Univariate analysis showed small MSA (MSA< 5 mm2) and irregular protrusion were correlated with MACE at 1year follow up (P=0.003 and P=0.044). Following adjustment of stent edge dissection, incomplete stent apposition, irregular protrusion, small MSA, stent type, and clinical presentations, small MSA and irregular protrusion remain as independent predictors of MACE (P=0.004 and P=0.037).
Conclusions: OCT-detected stent complication rate is high. Small MSA and irregular protrusion are independent predictors of MACE at 1 year.
Author Disclosures: T. Soeda: None. S. Park: None. Y. Jang: None. S. Lee: None. O. Raffel: None. S. Choi: None. S. Chia: None. T. Itoh: None. C. Toma: None. H. Jia: None. Y. Minami: None. R. Vergallo: None. J. Tian: None. S. Hu: None. H. Lee: None. B. Yu: None. S. Uemura: None. Y. Saito: None. I. Jang: None.
- © 2014 by American Heart Association, Inc.