Post-Stent Optical Coherence Tomography Findings at Index Percutaneous Coronary Intervention - Characteristics Related to Subsequent Stent Thrombosis

Circ J. 2021 May 25;85(6):857-866. doi: 10.1253/circj.CJ-20-0759. Epub 2021 Jan 27.

Abstract

Background: The association between unfavorable post-stent optical coherence tomography (OCT) findings and subsequent stent thrombosis (ST) remains unclear. This study investigated the ST-related characteristics of post-stent OCT findings at index percutaneous coronary intervention (PCI).

Methods and results: Fifteen patients with ST onset after OCT-guided PCI (ST group) were retrospectively enrolled. Post-stent OCT findings in the ST group were compared with those in 70 consecutive patients (reference group) without acute coronary syndrome onset for at least 5 years after OCT-guided PCI. The incidence of acute myocardial infarction (AMI) was higher in the ST than reference group (60.0% vs. 17.1%, respectively; P=0.0005). The incidence of incomplete stent apposition (93.3% vs. 55.7%; P=0.0064), irregular protrusion (IP; 93.3% vs. 62.8%; P=0.0214), and thrombus (93.3% vs. 51.4%; P=0.0028) was significantly higher in the ST than reference group. The maximum median (interquartile range) IP arc was significantly larger in the ST than reference group (265° [217°-360°] vs. 128° [81.4°-212°], respectively; P<0.0001). In AMI patients, the incidence of a maximum IP arc >180° was significantly higher in the ST than reference group (100% vs. 58.3%, respectively; P=0.0265).

Conclusions: IP with a large arc was a significant feature on post-stent OCT in patients with ST.

Keywords: Irregular protrusion; Post-stent optical coherence tomography findings; Stent thrombosis.

MeSH terms

  • Coronary Angiography
  • Coronary Thrombosis* / diagnostic imaging
  • Coronary Thrombosis* / etiology
  • Coronary Vessels / diagnostic imaging
  • Humans
  • Myocardial Infarction
  • Percutaneous Coronary Intervention* / adverse effects
  • Retrospective Studies
  • Stents* / adverse effects
  • Thrombosis
  • Tomography, Optical Coherence
  • Treatment Outcome