Ishida Kohki, Otsuki Shuji, Giacchi Giuseppe, Ortega-Paz Luis, Shiratori Yoshitaka, Freixa Xavier, Martín-Yuste Victoria, Masotti Mónica, Sabaté Manel, Brugaletta Salvatore
Cardiology Department, Cardiovascular Institute, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain.
Division of Cardiology, Teikyo University Hospital, Tokyo, Japan.
Cardiovasc Revasc Med. 2017 Jan-Feb;18(1):47-52. doi: 10.1016/j.carrev.2016.08.010. Epub 2016 Sep 4.
Incomplete stent apposition (ISA) is related to stent thrombosis, which is a serious adverse event. We aim to assess the time-course of ISA after 2nd generation everolimus-eluting stent (EES) implantation.
In HEAL-EES study, we enrolled 36 patients who underwent percutaneous coronary intervention (PCI) with EES. OCT imaging was performed at baseline and follow-up. Patients were randomized 1:1:1 into 3 groups according to the time in which follow-up was performed: group A (6-month), group B (9-month), and group C (12-month). In this subanalysis, patients who had ISA segments at baseline and/or follow-up OCT were analyzed.
At baseline, among 41 lesions in 36 patients, 20 lesions in 18 patients had ISA segments and were analyzed. At baseline, there were 3.0% ISA struts in group A (n=8), 2.8% in group B (n=4), and 4.5% in group C (n=8). At follow-up, ISA struts were present in 0.09%, 0.16% and 0.64%; respectively in groups A, B, and C. At follow-up, there was a significant decrease in the frequency of ISA: group A 3.0% vs. 0.09% (p<0.001), group B 2.8% vs. 0.16% (p<0.001), and group C 4.5% vs. 0.64% (p<0.001). In group A, there was one late acquired ISA at follow-up.
In patients undergoing 2nd generation EES implantation, area of acute ISA assessed by OCT, was almost resolved at 6-month follow-up.
支架贴壁不全（ISA）与支架内血栓形成相关，而支架内血栓形成是一种严重的不良事件。我们旨在评估第二代依维莫司洗脱支架（EES）植入术后ISA的时间进程。
在HEAL-EES研究中，我们纳入了36例行EES经皮冠状动脉介入治疗（PCI）的患者。在基线和随访时进行光学相干断层扫描（OCT）成像。根据随访时间将患者按1:1:1随机分为3组：A组（6个月）、B组（9个月）和C组（12个月）。在这项亚分析中，对基线和/或随访OCT时有ISA节段的患者进行分析。
基线时，36例患者的41个病变中，18例患者的20个病变有ISA节段并进行了分析。基线时，A组（n = 8）的ISA支架为3.0%，B组（n = 4）为2.8%，C组（n = 8）为4.5%。随访时，A组、B组和C组的ISA支架分别为0.09%、0.16%和0.64%。随访时，ISA的频率显著降低：A组3.0%对0.09%（p<0.001），B组2.8%对0.16%（p<0.001），C组4.5%对0.64%（p<0.001）。A组在随访时有1例迟发性获得性ISA。
在接受第二代EES植入的患者中，通过OCT评估的急性ISA区域在6个月随访时几乎消失。
