Comparison of serial optical coherence tomography imaging following aggressive stent expansion technique: insight from the MECHANISM study View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2020-10-09

AUTHORS

Wataru Sasaki, Masaru Ishida, Tomonori Itoh, Yohei Uchimura, Hideto Oda, Yuya Taguchi, Kyosuke Kaneko, Tsubasa Sakamoto, Iwao Goto, Masafumi Sakuma, Daisuke Terashita, Hiromasa Otake, Toshiro Shinke, Yoshihiro Morino

ABSTRACT

To compare early vascular healing following cobalt-chromium everolimus-eluting stent (CoCr-EES) implantation between groups with or without aggressive stent expansion in patients treated by CoCr-EES for stable coronary artery disease (CAD). Seventy-one stable CAD lesions underwent CoCr-EES implantation and analysis of serial optical coherence tomography (OCT) images obtained post-procedure and at early-term (1- or 3-month) follow-up. The endpoints of this study were neointimal thickness at the time of 1- or 3-month OCT and presence and healing of stent edge dissection. Aggressive stent expansion was defined as a lesion complying with ILUMIEN III sizing protocol; that is, external elastic lamina (EEL) diameter minus maximum balloon diameter ≤ 0.25 mm. Comparing groups with and without aggressive stent expansion, median neointimal thickness at 1 and 3 months after CoCr-EES implantation was similar (1 month: 0.031 mm vs. 0.041 mm, respectively, p = 0.27; 3 months: 0.036 mm vs. 0.040 mm, respectively, p = 0.84). Regarding stent edge findings, the presence of any stent edge dissection immediately after percutaneous coronary intervention was also similar between the groups (25% vs. 15%, respectively; p = 0.30) and most stent edge dissections resolved completely within 3 months, regardless of location or dissection severity. After 1 year, no clinically driven target lesion revascularization or stent thrombosis was observed in either cohort. Even after aggressive stent expansion, early neointimal proliferation appeared modest with CoCr-EES implantation, and most stent edge dissections had resolved by 3 months. These findings may support the feasibility of EEL-based sizing by pre-stenting OCT. More... »

PAGES

419-428

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s10554-020-02047-5

DOI

http://dx.doi.org/10.1007/s10554-020-02047-5

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1131544541

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/33034867


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28 schema:description To compare early vascular healing following cobalt-chromium everolimus-eluting stent (CoCr-EES) implantation between groups with or without aggressive stent expansion in patients treated by CoCr-EES for stable coronary artery disease (CAD). Seventy-one stable CAD lesions underwent CoCr-EES implantation and analysis of serial optical coherence tomography (OCT) images obtained post-procedure and at early-term (1- or 3-month) follow-up. The endpoints of this study were neointimal thickness at the time of 1- or 3-month OCT and presence and healing of stent edge dissection. Aggressive stent expansion was defined as a lesion complying with ILUMIEN III sizing protocol; that is, external elastic lamina (EEL) diameter minus maximum balloon diameter ≤ 0.25 mm.  Comparing groups with and without aggressive stent expansion, median neointimal thickness at 1 and 3 months after CoCr-EES implantation was similar (1 month: 0.031 mm vs. 0.041 mm, respectively, p = 0.27; 3 months: 0.036 mm vs. 0.040 mm, respectively, p = 0.84). Regarding stent edge findings, the presence of any stent edge dissection immediately after percutaneous coronary intervention was also similar between the groups (25% vs. 15%, respectively; p = 0.30) and most stent edge dissections resolved completely within 3 months, regardless of location or dissection severity. After 1 year, no clinically driven target lesion revascularization or stent thrombosis was observed in either cohort. Even after aggressive stent expansion, early neointimal proliferation appeared modest with CoCr-EES implantation, and most stent edge dissections had resolved by 3 months. These findings may support the feasibility of EEL-based sizing by pre-stenting OCT.
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35 CoCr-EES
36 CoCr-EES implantation
37 aggressive stent expansion
38 analysis
39 artery disease
40 balloon diameter
41 cobalt-chromium everolimus-eluting stent (CoCr-EES) implantation
42 coherence tomography
43 cohort
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45 coronary artery disease
46 coronary intervention
47 diameter
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49 dissection
50 dissection severity
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61 group
62 healing
63 images
64 implantation
65 insights
66 intervention
67 lesion revascularization
68 lesions
69 location
70 maximum balloon diameter
71 mechanism study
72 median neointimal thickness
73 months
74 neointimal proliferation
75 neointimal thickness
76 optical coherence tomography
77 optical coherence tomography images
78 patients
79 percutaneous coronary intervention
80 presence
81 proliferation
82 protocol
83 revascularization
84 serial optical coherence tomography
85 serial optical coherence tomography (OCT) images
86 severity
87 sizing
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89 stable coronary artery disease
90 stent edge dissection
91 stent expansion
92 stent implantation
93 stent thrombosis
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