Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, Seoul 120-752, Korea.
Int J Cardiovasc Imaging. 2012 Aug;28(6):1289-97. doi: 10.1007/s10554-011-9944-9. Epub 2011 Aug 24.
Minimal data have been published on the correlation between angiographic late loss (LL) and incomplete neointimal coverage of struts after drug-eluting stent (DES) implantation. Therefore, we evaluated the relationship between angiographic LL and the percentage of uncovered struts on follow-up optical coherence tomography (OCT) images, in all cross-sections of the lesions. From the OCT registry database, 219 lesions without restenosis after DES implantation were divided into tertiles based on angiographic LL: tertile I (LL ≤ 0.26 mm), tertile II (0.26 < LL < 0.59 mm), and tertile III (≥0.59 mm). Lesions with the percentage of uncovered struts in the highest quartile (≥75th percentile; >6.0%) were defined as highly uncovered; in an independent analysis, lesions without any uncovered strut(s) were defined as completely covered. Higher percentages of uncovered struts were observed in tertile I than in both tertile II and III (10.3 ± 12.8% vs. 4.2 ± 7.4% vs. 2.4 ± 5.1%, respectively; P < 0.001 for I vs. II and I vs. III). Angiographic LL correlated significantly with the percentage of uncovered struts on OCT (r = -0.340, P < 0.001). The best cut-off values of angiographic LL to predict highly uncovered and completely covered lesions were 0.29 mm (area under curves [AUC] = 0.723, P < 0.001) and 0.61 mm (AUC = 0.692, P < 0.001), respectively. Angiographic LL inversely and significantly correlated with the percentage of uncovered struts on OCT after DES implantation.
关于药物洗脱支架（DES）植入后血管造影晚期丢失（LL）与支架内不完全内膜覆盖之间的相关性，已有少量数据发表。因此，我们评估了在所有病变节段的光学相干断层扫描（OCT）图像的随访中，血管造影 LL 与未覆盖支架百分比之间的关系。从 OCT 注册数据库中，根据血管造影 LL 将 219 例 DES 植入后无再狭窄的病变分为 3 组：第 1 组（LL≤0.26mm）、第 2 组（0.26mm<LL<0.59mm）和第 3 组（≥0.59mm）。将未覆盖支架百分比最高四分位数（≥第 75 百分位数；>6.0%）定义为高度未覆盖；在独立分析中，将无任何未覆盖支架的病变定义为完全覆盖。第 1 组的未覆盖支架百分比高于第 2 组和第 3 组（10.3±12.8%比 4.2±7.4%比 2.4±5.1%；P<0.001 用于 I 与 II 和 I 与 III）。血管造影 LL 与 OCT 上未覆盖支架的百分比显著相关（r=-0.340，P<0.001）。预测高度未覆盖和完全覆盖病变的最佳血管造影 LL 截断值分别为 0.29mm（曲线下面积[AUC]=0.723，P<0.001）和 0.61mm（AUC=0.692，P<0.001）。DES 植入后，血管造影 LL 与 OCT 上未覆盖支架的百分比呈负相关且显著相关。
