Incidence and Clinical Significance of Post-Stent OCT Findings: One Year Follow-Up Study From a Multicenter Registry
Background—Optical coherence tomography (OCT) was recently introduced to optimize percutaneous coronary intervention. However, the exact incidence and significance of post-stent OCT findings are unknown.
Methods and Results—A total of 900 lesions treated with 1001 stents in 786 patients who had post-procedure OCT imaging were analyzed to evaluate the incidence of post-stent OCT findings and to identify the OCT predictors for device-oriented clinical endpoints (DoCE), including cardiac death, target vessel-related myocardial infarction, target lesion revascularization (TLR) and stent thrombosis. Patients were followed up to 1 year. Stent edge dissection was detected in 28.7% of lesions and incomplete stent apposition in 39.1% of lesions. The incidences of smooth protrusion, disrupted fibrous tissue protrusion, and irregular protrusion were 92.9%, 61.0%, and 53.8%, respectively. Small minimal stent area (MSA), defined as a lesion with MSA <5.0 mm2 in a drug eluting stent or <5.6 mm2 in a bare metal stent, was observed in 40.4% of lesions. One-year DoCE occurred in 33 patients (4.5%). Following adjustment, irregular protrusion and small MSA were independent OCT predictors of 1-year DoCE (P=0.003 and P=0.012, respectively).
Conclusions—Abnormal post-stent OCT findings were frequent. Irregular protrusion and small MSA were independent predictors of 1-year DoCE, which was primarily driven by TLR.
- Received December 5, 2014.
- Revision received June 6, 2015.
- Accepted July 6, 2015.