Abstract 17854: Relationship Between Tissue Prolapse After Percutaneous Coronary Intervention and Its Relation With Neointimal Hyperplasia at Follow-up by Serial Optical Coherence Tomography Examination
Background: Tissue prolapse (TP) after stent implantation is sometimes observed on optical coherence tomography (OCT) after percutaneous coronary intervention (PCI). However, the clinical significance of TP on long-term outcomes has not been fully investigated. We sought to evaluate the relationship between TP just after PCI and neointimal hyperplasia (NIH) at the follow-up period by serial OCT examination.
Methods: We evaluated 106 consecutive lesions in 106 patients (46 patients with acute coronary syndrome [ACS]; 60 patients with stable angina pectoris [SAP]) that underwent PCI with OCT examination. All lesions were treated with stent implantation (60 lesions with drug-eluting stents; 46 lesions with bare metal stents). Before PCI, plaque morphologies at the culprit sites on OCT were evaluated. TP after PCI was defined as tissue extrusion through the stent struts. TP area in each cross-sectional area (CSA) and TP volume defined as the sum of TP area in each CSA at 1-mm intervals throughout the stented segments were measured. At follow-up coronary angiography (mean interval: 8.8 ± 2.2 months), NIH area in each CSA and NIH volume throughout the stented segments were also measured. The relationships between TP just after PCI and NIH at follow-up angiography at the culprit sites, at the most protruding sites, and throughout the stented segments were evaluated.
Results: TP area after PCI was correlated with underlying lipid arc and fibrous cap thickness at the culprit sites (lipid arc, r = 0.26, p = 0.02; cap thickness, r = -0.30, p = 0.008) and at the most protruding sites (r = 0.36, p = 0.0003 and r = -0.39, p = 0.0001), respectively. TP volume throughout the stented segment after PCI was correlated with NIH volume at follow-up (r = 0.46, p = 0.0001). In ACS lesions, TP area after PCI was correlated with NIH area at follow-up at the culprit sites (r = 0.33, p = 0.03) and at the most protruding sites (r = 0.34, p = 0.03). In SAP lesions, TP area at the most protruding sites was correlated with NIH area (r = 0.29, p = 0.04), but not at the culprit site.
Conclusion: TP just after PCI was correlated with the underlying plaque morphologies at the culprit sites on OCT and related with the degrees of NIH at the follow-up period. The amount of TP might influence the long-term stent outcomes.
Author Disclosures: T. Sugiyama: None. S. Kimura: None. Y. Yamakami: None. K. Kojima: None. Y. Sagawa: None. H. Ohtani: None. K. Hishikari: None. H. Hikita: None. A. Takahashi: None. M. Isobe: None.
- © 2014 by American Heart Association, Inc.