Natural History of Stent Edge Dissection, Tissue Protrusion and Incomplete Stent Apposition Detectable Only on Optical Coherence Tomography After Stent Implantation - Preliminary Observation
Natural History of Stent Edge Dissection, Tissue Protrusion and Incomplete Stent Apposition Detectable Only on Optical Coherence Tomography After Stent Implantation - Preliminary Observation
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DOI：
10.1253/circj.cj-11-0845
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发表时间：
2012-03-01
影响因子：
3.3
通讯作者：
Yoshida, Kiyoshi
中科院分区：
文献类型：
--
作者：
Kume, Teruyoshi;Okura, Hiroyuki;Yoshida, Kiyoshi
背景：支架植入后支架边缘夹层、组织突出和支架不完全贴置（ISA）的临床影响，仅在光学相干断层扫描（OCT）上可检测到，由于尚未研究其自然过程，目前尚不清楚。方法和结果：所有连续的心绞痛患者均在支架置入后和随访中立即行血管内超声（IVUS）和OCT检查。观察随访期间oct检测支架边缘剥离、组织突出和ISA的自然历史。共分析36例患者39个病变。基线时，OCT显示12个支架边缘夹层，25个组织突出，8个isa，而IVUS显示6个支架边缘夹层，5个组织突出，3个isa。所有IVUS结果在OCT上显示清晰，OCT上显示的夹层皮瓣最大长度和ISA深度明显短于IVUS。OCT上组织突出的最大长度往往小于IVUS。在随访中（中位188天），所有OCT检查结果均愈合或消退，无再狭窄或血栓形成。结论：支架置入术后的急性表现，如边缘剥离、组织突出和ISA，仅在OCT上可检测到，往往比在OCT和IVUS上所见的要小。大多数oct检测到的急性症状在随访时完全消失。（Circ J 2012; 76: 698-703）
Background: The clinical impact of stent edge dissection, tissue protrusion, and incomplete stent apposition (ISA) after stent implantation, detectable only on optical coherence tomography (OCT), is still unknown because the natural course has not been investigated.Methods and Results: All consecutive patients with angina pectoris in whom both intravascular ultrasound (IVUS) and OCT were performed immediately after stenting and at follow-up were included in the present study. The natural history of OCT-detected stent edge dissection, tissue protrusion, and ISA during follow-up was investigated. A total of 36 patients with 39 lesions was analyzed. At baseline, OCT showed 12 stent edge dissections, 25 tissue protrusions, and 8 ISAs, whereas IVUS demonstrated 6 stent edge dissections, 5 tissue protrusions, and 3 ISAs. All IVUS findings were clearly visualized on OCT. The maximum length of dissection flap and depth of ISA visualized on OCT were significantly shorter than those visualized on IVUS. Maximum length of tissue protrusion tended to be smaller on OCT than on IVUS. At follow-up (median 188 days), all findings noted on OCT were healed or resolved without any restenosis or thrombus formation.Conclusions: Acute findings after stenting, such as edge dissection, tissue protrusion, and ISA, detectable only on OCT, tended to be smaller than those seen on both OCT and IVUS. The majority of OCT-detected acute findings resolved completely at follow-up. (Circ J 2012; 76: 698-703)