Optical Coherence Tomography Findings in Patients With Coronary
Stent Thrombosis A Report of the PRESTIGE Consortium
(Prevention of Late Stent Thrombosis by an Interdisciplinary
Global European Effort)

J 2017

Optical Coherence Tomography Findings in Patients With Coronary Stent Thrombosis A Report of the PRESTIGE Consortium (Prevention of Late Stent Thrombosis by an Interdisciplinary Global European Effort)

ADRIAENSSENS, T., M. JONER, T.C. GODSCHALK, N. MALIK, F. ALFONSO et. al.

Basic information

Original name

Optical Coherence Tomography Findings in Patients With Coronary Stent Thrombosis A Report of the PRESTIGE Consortium (Prevention of Late Stent Thrombosis by an Interdisciplinary Global European Effort)

Authors

ADRIAENSSENS, T. (56 Belgium), M. JONER (276 Germany), T.C. GODSCHALK (528 Netherlands), N. MALIK (826 United Kingdom of Great Britain and Northern Ireland), F. ALFONSO (724 Spain), E. XHEPA (276 Germany), D. DE COCK (56 Belgium), K. KOMUKAI (380 Italy), T. TADA (276 Germany), J. CUESTA (724 Spain), V. SIRBU (380 Italy), L.J. FELDMAN (250 France), F.J. NEUMANN (276 Germany), A.H. GOODALL (826 United Kingdom of Great Britain and Northern Ireland), T. HEESTERMANS (528 Netherlands), I. BUYSSCHAERT (56 Belgium), Ota HLINOMAZ (203 Czech Republic, guarantor, belonging to the institution), A. BELMANS (56 Belgium), W. DESMET (56 Belgium), J.M. ten BERG (528 Netherlands), A.H. GERSHLICK (826 United Kingdom of Great Britain and Northern Ireland), S. MASSBERG (276 Germany), A. KASTRATI (276 Germany), G. GUAGLIUMI (380 Italy) and R.A. BYRNE (276 Germany)

Edition

Circulation, Philadelphia, Lippincott Williams Wilkins, 2017, 0009-7322

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30201 Cardiac and Cardiovascular systems

Country of publisher

United States of America

Confidentiality degree

není předmětem státního či obchodního tajemství

Impact factor

Impact factor: 18.881

RIV identification code

RIV/00216224:14110/17:00099994

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1161/CIRCULATIONAHA.117.026788

UT WoS

000410062800007

Keywords in English

atherosclerosis; malapposition; stents; thrombosis; tomography; optical coherence; uncovered struts

Abstract

V originále

BACKGROUND: Stent thrombosis (ST) is a serious complication following coronary stenting. Intravascular optical coherence tomography (OCT) may provide insights into mechanistic processes leading to ST. We performed a prospective, multicenter study to evaluate OCT findings in patients with ST. METHODS: Consecutive patients presenting with ST were prospectively enrolled in a registry by using a centralized telephone registration system. After angiographic confirmation of ST, OCT imaging of the culprit vessel was performed with frequency domain OCT. Clinical data were collected according to a standardized protocol. OCT acquisitions were analyzed at a core laboratory. Dominant and contributing findings were adjudicated by an imaging adjudication committee. RESULTS: Two hundred thirty-one patients presenting with ST underwent OCT imaging; 14 (6.1%) had image quality precluding further analysis. Of the remaining patients, 62 (28.6%) and 155 (71.4%) presented with early and late/very late ST, respectively. The underlying stent type was a new-generation drug-eluting stent in 50.3%. Mean reference vessel diameter was 2.9+/-0.6 mm and mean reference vessel area was 6.8+/-2.6 mm(2). Stent underexpansion (stent expansion index <0.8) was observed in 44.4% of patients. The predicted average probability (95% confidence interval) that any frame had uncovered (or thrombus-covered) struts was 99.3% (96.1-99.9), 96.6% (92.4-98.5), 34.3% (15.0-60.7), and 9.6% (6.2-14.5) and malapposed struts was 21.8% (8.4-45.6), 8.5% (4.6-15.3), 6.7% (2.5-16.3), and 2.0% (1.2-3.3) for acute, subacute, late, and very late ST, respectively. The most common dominant finding adjudicated for acute ST was uncovered struts (66.7% of cases); for subacute ST, the most common dominant finding was uncovered struts (61.7%) and underexpansion (25.5%); for late ST, the most common dominant finding was uncovered struts (33.3%) and severe restenosis (19.1%); and for very late ST, the most common dominant finding was neoatherosclerosis (31.3%) and uncovered struts (20.2%). In patients presenting very late ST, uncovered stent struts were a common dominant finding in drug-eluting stents, and neoatherosclerosis was a common dominant finding in bare metal stents. CONCLUSIONS: In patients with ST, uncovered and malapposed struts were frequently observed with the incidence of both decreasing with longer time intervals between stent implantation and presentation. The most frequent dominant observation varied according to time intervals from index stenting: uncovered struts and underexpansion in acute/subacute ST and neoatherosclerosis and uncovered struts in late/very late ST.

Citovat

ADRIAENSSENS, T., M. JONER, T.C. GODSCHALK, N. MALIK, F. ALFONSO, E. XHEPA, D. DE COCK, K. KOMUKAI, T. TADA, J. CUESTA, V. SIRBU, L.J. FELDMAN, F.J. NEUMANN, A.H. GOODALL, T. HEESTERMANS, I. BUYSSCHAERT, Ota HLINOMAZ, A. BELMANS, W. DESMET, J.M. ten BERG, A.H. GERSHLICK, S. MASSBERG, A. KASTRATI, G. GUAGLIUMI and R.A. BYRNE. Optical Coherence Tomography Findings in Patients With Coronary Stent Thrombosis A Report of the PRESTIGE Consortium (Prevention of Late Stent Thrombosis by an Interdisciplinary Global European Effort). Circulation. Philadelphia: Lippincott Williams Wilkins, 2017, vol. 136, No 11, p. "1007"-"+", 31 pp. ISSN 0009-7322. Available from: https://dx.doi.org/10.1161/CIRCULATIONAHA.117.026788.

@article{1408002,
   author = {Adriaenssens, T. and Joner, M. and Godschalk, T.C. and Malik, N. and Alfonso, F. and Xhepa, E. and De Cock, D. and Komukai, K. and Tada, T. and Cuesta, J. and Sirbu, V. and Feldman, L.J. and Neumann, F.J. and Goodall, A.H. and Heestermans, T. and Buysschaert, I. and Hlinomaz, Ota and Belmans, A. and Desmet, W. and Berg, J.M. ten and Gershlick, A.H. and Massberg, S. and Kastrati, A. and Guagliumi, G. and Byrne, R.A.},
   article_location = {Philadelphia},
   article_number = {11},
   doi = {http://dx.doi.org/10.1161/CIRCULATIONAHA.117.026788},
   keywords = {atherosclerosis; malapposition; stents; thrombosis; tomography; optical coherence; uncovered struts},
   language = {eng},
   issn = {0009-7322},
   journal = {Circulation},
   title = {Optical Coherence Tomography Findings in Patients With Coronary Stent Thrombosis A Report of the PRESTIGE Consortium (Prevention of Late Stent Thrombosis by an Interdisciplinary Global European Effort)},
   volume = {136},
   year = {2017}
}

TY  - JOUR
ID  - 1408002
AU  - Adriaenssens, T. - Joner, M. - Godschalk, T.C. - Malik, N. - Alfonso, F. - Xhepa, E. - De Cock, D. - Komukai, K. - Tada, T. - Cuesta, J. - Sirbu, V. - Feldman, L.J. - Neumann, F.J. - Goodall, A.H. - Heestermans, T. - Buysschaert, I. - Hlinomaz, Ota - Belmans, A. - Desmet, W. - Berg, J.M. ten - Gershlick, A.H. - Massberg, S. - Kastrati, A. - Guagliumi, G. - Byrne, R.A.
PY  - 2017
TI  - Optical Coherence Tomography Findings in Patients With Coronary Stent Thrombosis A Report of the PRESTIGE Consortium (Prevention of Late Stent Thrombosis by an Interdisciplinary Global European Effort)
JF  - Circulation
VL  - 136
IS  - 11
SP  - "1007"-"+"
EP  - "1007"-"+"
PB  - Lippincott Williams Wilkins
SN  - 00097322
KW  - atherosclerosis
KW  - malapposition
KW  - stents
KW  - thrombosis
KW  - tomography
KW  - optical coherence
KW  - uncovered struts
N2  - BACKGROUND: Stent thrombosis (ST) is a serious complication following coronary stenting. Intravascular optical coherence tomography (OCT) may provide insights into mechanistic processes leading to ST. We performed a prospective, multicenter study to evaluate OCT findings in patients with ST. METHODS: Consecutive patients presenting with ST were prospectively enrolled in a registry by using a centralized telephone registration system. After angiographic confirmation of ST, OCT imaging of the culprit vessel was performed with frequency domain OCT. Clinical data were collected according to a standardized protocol. OCT acquisitions were analyzed at a core laboratory. Dominant and contributing findings were adjudicated by an imaging adjudication committee. RESULTS: Two hundred thirty-one patients presenting with ST underwent OCT imaging; 14 (6.1%) had image quality precluding further analysis. Of the remaining patients, 62 (28.6%) and 155 (71.4%) presented with early and late/very late ST, respectively. The underlying stent type was a new-generation drug-eluting stent in 50.3%. Mean reference vessel diameter was 2.9+/-0.6 mm and mean reference vessel area was 6.8+/-2.6 mm(2). Stent underexpansion (stent expansion index <0.8) was observed in 44.4% of patients. The predicted average probability (95% confidence interval) that any frame had uncovered (or thrombus-covered) struts was 99.3% (96.1-99.9), 96.6% (92.4-98.5), 34.3% (15.0-60.7), and 9.6% (6.2-14.5) and malapposed struts was 21.8% (8.4-45.6), 8.5% (4.6-15.3), 6.7% (2.5-16.3), and 2.0% (1.2-3.3) for acute, subacute, late, and very late ST, respectively. The most common dominant finding adjudicated for acute ST was uncovered struts (66.7% of cases); for subacute ST, the most common dominant finding was uncovered struts (61.7%) and underexpansion (25.5%); for late ST, the most common dominant finding was uncovered struts (33.3%) and severe restenosis (19.1%); and for very late ST, the most common dominant finding was neoatherosclerosis (31.3%) and uncovered struts (20.2%). In patients presenting very late ST, uncovered stent struts were a common dominant finding in drug-eluting stents, and neoatherosclerosis was a common dominant finding in bare metal stents. CONCLUSIONS: In patients with ST, uncovered and malapposed struts were frequently observed with the incidence of both decreasing with longer time intervals between stent implantation and presentation. The most frequent dominant observation varied according to time intervals from index stenting: uncovered struts and underexpansion in acute/subacute ST and neoatherosclerosis and uncovered struts in late/very late ST.
ER  -

ADRIAENSSENS, T., M. JONER, T.C. GODSCHALK, N. MALIK, F. ALFONSO, E. XHEPA, D. DE COCK, K. KOMUKAI, T. TADA, J. CUESTA, V. SIRBU, L.J. FELDMAN, F.J. NEUMANN, A.H. GOODALL, T. HEESTERMANS, I. BUYSSCHAERT, Ota HLINOMAZ, A. BELMANS, W. DESMET, J.M. ten BERG, A.H. GERSHLICK, S. MASSBERG, A. KASTRATI, G. GUAGLIUMI and R.A. BYRNE. Optical Coherence Tomography Findings in Patients With Coronary Stent Thrombosis A Report of the PRESTIGE Consortium (Prevention of Late Stent Thrombosis by an Interdisciplinary Global European Effort). \textit{Circulation}. Philadelphia: Lippincott Williams Wilkins, 2017, vol.~136, No~11, p.~''1007''-''+'', 31 pp. ISSN~0009-7322. Available from: https://dx.doi.org/10.1161/CIRCULATIONAHA.117.026788.

Detailed Information on Publication Record