Severe acute stent malapposition follow-up: 3-month and 12-month serial quantitative analyses by optical coherence tomography.

Abstract

BACKGROUND\nOptical coherence tomography (OCT) was used to assess serial changes in severe acute stent malapposition (ASM) after drug-eluting stent (DES) implantation.\n\n\nMETHODS\nThe maximal depth and axial lengths of ASM after DES implantation were serially quantified at percutaneous coronary intervention (PCI), and at 3 and 12-month follow-up, for 100 lesions in 96 patients. Severe ASM was defined as a maximal malapposed depth ≥400\u202fμm or maximal malapposed axial length ≥1\u202fmm.\n\n\nRESULTS\nOf the 100 lesions, 23 lesions (23%) had a severe ASM depth at PCI. At 3\u202fmonths, the maximal depth decreased to <400\u202fμm in 12 of 23 lesions (52%). At 12\u202fmonths, the maximal depth further decreased to <400\u202fμm in 8 of the remaining 11 lesions (73%). Similarly, of 53 lesions (53%) with a severe ASM length at PCI, the maximal length decreased to 0\u202fmm in 26 (49%) but remained severe in 17 lesions (32%) at 3\u202fmonths. At 12\u202fmonths, 9 of the 17 remaining lesions (53%) further decreased to 0\u202fmm. The cut-off values for the maximal malapposed depth and length to predict the absence of stent malapposition at 12\u202fmonths were 565\u202fμm at PCI and 165\u202fμm at 3\u202fmonths, and were 2.7\u202fmm at PCI and 0.1\u202fmm at 3\u202fmonths, respectively.\n\n\nCONCLUSION\nHalf of the severe ASM cases resolved within 3\u202fmonths, and another half resolved during 3-12\u202fmonths of follow-up. Our findings provide a better understanding of the time-dependent natural course of severe ASM using OCT.