Severance Cardiovascular Hospital, Seoul, Korea.
J Interv Cardiol. 2012 Jun;25(3):270-7. doi: 10.1111/j.1540-8183.2011.00706.x. Epub 2012 Feb 28.
Using optical coherence tomography (OCT), we evaluated the relationship between malapposed and uncovered struts following implantation of drug-eluting stents (DESs).
A total of 271 patients with 306 lesions who underwent DES implantation and follow-up OCT were included in the study. The lesions were grouped based on the presence of malapposition and then by the median value of the percentage of malapposed struts (1.3%) to produce 3 groups: lesions without malapposition (group I, n = 232) and those with percentage of malapposed struts <1.3% (group II, n = 37) or ≥1.3% (group III, n = 37). Percentages of malapposed and uncovered struts were calculated as percent ratio of malapposed or uncovered to total struts in the defined cross-sections, respectively. We compared percentage of uncovered struts in all analyzable struts and in the residual struts without malapposed segments among the 3 groups.
Group III showed a significantly larger percentage of uncovered struts among all the struts (group I, 3.7 ± 6.4 vs. II, 5.5 ± 5.6 vs. III, 17.6 ± 15.9%, P < 0.001) and among residual struts without malapposed segments (3.7 ± 6.4 vs. 5.2 ± 5.7 vs. 15.0 ± 14.4%, respectively, P < 0.001). There was a significant correlation between malapposed and uncovered struts in group III (r = 0.393, P = 0.016), but not in group II (r =-0.007, P = 0.965) among residual struts without malapposed segments.
The percentage of uncovered DES struts was quite different depending on the presence and extent of malapposed struts.
本研究采用光学相干断层扫描（OCT）评估药物洗脱支架（DES）植入术后贴壁不良和未覆盖支架的关系。
共纳入 271 例 306 处病变患者，这些患者均接受 DES 植入术并进行 OCT 随访。根据贴壁不良的存在情况对病变进行分组，然后根据贴壁不良支架的中位数百分比（1.3%）将病变进一步分为 3 组：无贴壁不良的病变（I 组，n = 232），贴壁不良支架百分比<1.3%的病变（II 组，n = 37）和贴壁不良支架百分比≥1.3%的病变（III 组，n = 37）。分别计算定义的横截面上贴壁不良和未覆盖支架的比例，计算贴壁不良和未覆盖支架的百分比。比较 3 组中所有可分析支架和无贴壁不良节段的残留支架中未覆盖支架的百分比。
III 组所有支架的未覆盖支架百分比明显大于其他两组（I 组：3.7 ± 6.4%；II 组：5.5 ± 5.6%；III 组：17.6 ± 15.9%，P<0.001），无贴壁不良节段的残留支架的未覆盖支架百分比也明显大于其他两组（I 组：3.7 ± 6.4%；II 组：5.2 ± 5.7%；III 组：15.0 ± 14.4%，P<0.001）。无贴壁不良节段的残留支架中，III 组贴壁不良和未覆盖支架之间存在显著相关性（r = 0.393，P = 0.016），但 II 组无相关性（r =-0.007，P = 0.965）。
根据贴壁不良支架的存在和程度，DES 未覆盖支架的比例有很大差异。
