Causes of Very Late Stent Thrombosis Investigated Using Optical Coherence Tomography

被引:9
作者
Amioka, Michitaka [1 ]
Shiode, Nobuo [1 ]
Kawase, Tomoharu [1 ]
Kagawa, Yuzo [1 ]
Yamane, Kenichi [1 ]
Takahashi, Lisa [1 ]
Okubo, Yousaku [1 ]
Tamekiyo, Hiromichi [1 ]
Otsuka, Masaya [1 ]
Okimoto, Tomokazu [1 ]
Masaoka, Yoshiko [1 ]
Hayashi, Yasuhiko [1 ]
Itakura, Kiho [2 ]
Kato, Masaya [2 ]
Dote, Keigo [2 ]
Kihara, Yasuki [3 ]
机构
[1] Akane Fdn Tsuchiya Gen Hosp, Div Cardiol, Ctr Cardiovasc, Hiroshima, Japan
[2] Hiroshima City Asa Hosp, Dept Cardiol, Hiroshima, Japan
[3] Hiroshima Univ, Sch Med, Dept Cardiol, Hiroshima 730, Japan
关键词
optical coherence tomography; very late stent thrombosis; drug-eluting stent; SIROLIMUS-ELUTING STENT; INTRAVASCULAR ULTRASOUND ANALYSIS; LARGE 2-INSTITUTIONAL COHORT; ROUTINE CLINICAL-PRACTICE; CORONARY STENT; ANTIPLATELET THERAPY; FOLLOW-UP; IMPLANTATION; RESTENOSIS; APPOSITION;
D O I
10.2169/internalmedicine.53.2177
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective Very late stent thrombosis (VLST) remains an unresolved problem, and recent reports have indicated that VLST onset can occur in patients treated with both drug-eluting stents (DES) and bare metal stents (BMS). We evaluated the causes of VLST using optical coherence tomography (OCT). Methods OCT was performed in 22 patients (12 DES-treated patients, 10 BMS-treated patients). Because two instances of VLST occurred simultaneously in one case in the DES group, the DES group comprised 13 lesions, while the BMS group comprised 10 lesions. All struts were counted in each frame, and the proportion of uncovered or malapposed struts was calculated based on the overall number of struts in the stent. Results The interval from stent implantation to VLST onset was significantly longer in the BMS group. The proportion of uncovered struts and the ratio of malapposed struts were significantly higher in the DES group than in the BMS group. The OCT analysis demonstrated intimal hyperplasia or intimal disruption in all patients in the BMS group. However, in the DES group, severe hyperplasia and/or neoatherosclerosis was observed in only eight lesions (61.5%), while uncovered and malapposed struts were involved in the other lesions. Conclusion In most BMS-treated lesions, it appeared that VLST was caused by the occurrence of neoatherosclerosis after stent implantation. The causes of VLST in DES-treated lesions are more various and complicated than those observed for BMS-treated lesions.
引用
收藏
页码:2031 / 2039
页数:9
相关论文
共 29 条
[1]   Incidence and predictors of drug-eluting stent thrombosis during and after discontinuation of thienopyridine treatment [J].
Airoldi, Flavio ;
Colombo, Antonio ;
Morici, Nuccia ;
Latib, Azeem ;
Cosgrave, John ;
Buellesfeld, Lutz ;
Bonizzoni, Erminio ;
Carlino, Mauro ;
Gerckens, Ulrich ;
Godino, Cosmo ;
Melzi, Gloria ;
Michev, Iassen ;
Montorfano, Matteo ;
Sangiorgi, Giuseppe Massimo ;
Qasim, Asif ;
Chieffo, Alaide ;
Briguori, Carlo ;
Grube, Eberhard .
CIRCULATION, 2007, 116 (07) :745-754
[2]   Late incomplete stent apposition after sirolimus-eluting stent implantation - A serial intravascular ultrasound analysis [J].
Ako, J ;
Morino, Y ;
Honda, Y ;
Hassan, A ;
Sonoda, S ;
Yock, PG ;
Leon, MB ;
Moses, JW ;
Bonneau, HN ;
Fitzgerald, PJ .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2005, 46 (06) :1002-1005
[3]   Very late stent thrombosis related to incomplete neointimal coverage or neoatherosclerotic plaque rupture identified by optical coherence tomography imaging [J].
Amabile, Nicolas ;
Souteyrand, Geraud ;
Ghostine, Said ;
Combaret, Nicolas ;
Slama, Michel S. ;
Barber-Chamoux, Nicolas ;
Motreff, Pascal ;
Caussin, Christophe .
EUROPEAN HEART JOURNAL-CARDIOVASCULAR IMAGING, 2014, 15 (01) :24-31
[4]   Randomized Comparison of the Nobori Biolimus A9-Eluting Coronary Stent With the Taxus Liberte Paclitaxel-Eluting Coronary Stent in Patients With Stenosis in Native Coronary Arteries The NOBORI 1 Trial - Phase 2 [J].
Chevalier, Bernard ;
Silber, Sigmund ;
Park, Seung-Jung ;
Garcia, Eulogio ;
Schuler, Gerhard ;
Suryapranata, Harry ;
Koolen, Jacques ;
Hauptmann, Karl E. ;
Wijns, William ;
Morice, Marie-Claude ;
Carrie, Didier ;
van Es, Gerrit-Anne ;
Nagai, Hirofumi ;
Detiege, Danny ;
Paunovic, Dragica ;
Serruys, Patrick W. .
CIRCULATION-CARDIOVASCULAR INTERVENTIONS, 2009, 2 (03) :188-U57
[5]   Incomplete stent apposition and very late stent thrombosis after drug-eluting stent implantation [J].
Cook, Stephane ;
Wenaweser, Peter ;
Togni, Mario ;
Billinger, Michael ;
Morger, Cyrill ;
Seiler, Christian ;
Vogel, Rolf ;
Hess, Otto ;
Meier, Bernhard ;
Windecker, Stephan .
CIRCULATION, 2007, 115 (18) :2426-2434
[6]   Clinical end points in coronary stent trials - A case for standardized definitions [J].
Cutlip, Donald E. ;
Windecker, Stephan ;
Mehran, Roxana ;
Boam, Ashley ;
Cohen, David J. ;
van Es, Gerrit-Anne ;
Steg, P. Gabriel ;
Morel, Marie-angele ;
Mauri, Laura ;
Vranckx, Pascal ;
McFadden, Eugene ;
Lansky, Alexandra ;
Hamon, Martial ;
Krucoff, Mitchell W. ;
Serruys, Patrick W. .
CIRCULATION, 2007, 115 (17) :2344-2351
[7]   Early and late coronary stent thrombosis of sirolimus-eluting and paclitaxel-eluting stents in routine clinical practice:: data from a large two-institutional cohort study [J].
Daemen, Joost ;
Wenaweser, Peter ;
Tsuchida, Keiichi ;
Abrecht, Linda ;
Sophia, Vaina ;
Morger, Cyrill ;
Kukreja, Neville ;
Jueni, Peter ;
Sianos, Georgios ;
Hellige, Gerrit ;
van Domburg, Ron T. ;
Hess, Otto M. ;
Boersma, Eric ;
Meier, Bernhard ;
Windecker, Stephan ;
Serruys, Patrick W. .
LANCET, 2007, 369 (9562) :667-678
[8]   Outcomes of stent thrombosis and restenosis during extended follow-up of patients treated with bare-metal coronary stents [J].
Doyle, Brendan ;
Rihal, Charanjit S. ;
O'Sullivan, Crochan J. ;
Lennon, Ryan J. ;
Wiste, Heather J. ;
Bell, Malcolm ;
Bresnahan, John ;
Holmes, David R., Jr. .
CIRCULATION, 2007, 116 (21) :2391-2398
[9]   Vascular responses to drug eluting stents - Importance of delayed healing [J].
Finn, Aloke V. ;
Nakazawa, Gaku ;
Joner, Michael ;
Kolodgie, Frank D. ;
Mont, Erik K. ;
Gold, Herman K. ;
Virmani, Renu .
ARTERIOSCLEROSIS THROMBOSIS AND VASCULAR BIOLOGY, 2007, 27 (07) :1500-1510
[10]   Pathological correlates of late drug-eluting stent thrombosis - Strut coverage as a marker of endothelialization [J].
Finn, Aloke V. ;
Joner, Michael ;
Nakazawa, Gaku ;
Kolodgie, Frank ;
Newell, John ;
John, Mike C. ;
Gold, Herman K. ;
Virmani, Renu .
CIRCULATION, 2007, 115 (18) :2435-2441