Stent edge restenosis continues to be a weakness of drug eluting stents (DES). The aim of this study was to determine its predictors using optical coherence tomography (OCT).
The study retrospectively analyzed 319 patients receiving OCT immediately after everolimus eluting stent implantation (EES) looking into the immediate outcome, and follow up angiography at 9 and 12 months.
Binary angiographic stent edge restenosis was 10%. OCT more often showed lipidic plaque in patients with stent edge restenosis vs. those without it. (61% vs. 20%; p<0.001), as well as smaller minimal lumen area (4.13±2.61 vs. 5.58±2.46 mm2; p=0.001). Multivariable analysis confirmed these two variables are significant predictors of stent edge restenosis.
A lipidic arc of 185° (sensitivity: 71%; specificity: 72%; area under the curve: 0.761) and minimal lumen area of 4.10 mm2 (sensitivity: 67%; specificity: 77%; area under the curve: 0.787) were the ideal cutoff values to predict stent edge restenosis.
These results do not come as a surprise since it is well known that plaque in the distal or proximal stent edges and stent underexpansion are restenosis predictors.
Conclusion
OCT provides decisive information on optimal stent diameter and expansion to select the right stent length, which in turn will allow us to cover the whole plaque.
Original Title: Optical Coherence Tomography Predictors for Edge Restenosis after Everolimus-Eluting Stent Implantation.
Reference: Ino Y et al. Circ Cardiovasc Interv. 2016 Oct; 9(10).
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