Comparison of Strut Coverage at 6 Months by Optical Coherence Tomography With Everolimus-Eluting Stenting of Bare-Metal Stent Restenosis Versus Stenosis of Nonstented Atherosclerotic Narrowing (from the DESERT Study)

Am J Cardiol. 2015 May 15;115(10):1351-6. doi: 10.1016/j.amjcard.2015.02.042. Epub 2015 Feb 18.

Abstract

Incomplete struts coverage is a predictor of late stent thrombosis after implantation of the drug-eluting stents (DES) in atherosclerotic lesions. The process of struts coverage in DES implanted for bare-metal stent (BMS) restenosis has never been described. Thirty-two patients with stable coronary artery disease were consecutively selected, 11 with BMS restenosis (group A) and 21 with de novo atherosclerotic lesions (group B). All patients underwent everolimus-eluting stent implantation; coronary angiography and optical coherence tomography were performed at 6 months follow-up. Percentage difference in struts coverage between the 2 groups was the primary end point. A total of 85,773 struts (17,891 in group A and 67,882 in group B) were analyzed: compared with group B, the percentage of uncovered stent struts was significantly lower in group A (2.6% vs 4.8%; p <0.0001). In group A, DES struts protruding out of BMS were more uncovered (5.0% vs 1.9%; p <0.0001) and malapposed (4.1% vs 2.1%; p <0.0001) compared with overlapping struts. In conclusion, when DES are implanted to treat BMS restenosis, struts coverage at 6 months follow-up is more complete compared with DES implanted in atherosclerotic lesions.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Antineoplastic Agents
  • Atherosclerosis / diagnosis*
  • Atherosclerosis / surgery
  • Coronary Angiography
  • Coronary Restenosis / diagnosis
  • Coronary Restenosis / surgery
  • Coronary Stenosis / diagnosis*
  • Coronary Stenosis / surgery
  • Coronary Vessels / pathology*
  • Coronary Vessels / surgery
  • Drug-Eluting Stents*
  • Electrocardiography
  • Everolimus
  • Follow-Up Studies
  • Immunosuppressive Agents / pharmacology
  • Prosthesis Design
  • Reproducibility of Results
  • Retrospective Studies
  • Single-Blind Method
  • Sirolimus / analogs & derivatives*
  • Sirolimus / pharmacology
  • Time Factors
  • Tomography, Optical Coherence / methods*

Substances

  • Antineoplastic Agents
  • Immunosuppressive Agents
  • Everolimus
  • Sirolimus