TY - JOUR
TI - Impact of coronary artery stent edge dissections on long-term clinical
outcome in patients with acute coronary syndrome: An optical coherence
tomography study
AU - Bouki, Konstantina P.
AU - Sakkali, Eleni
AU - Toutouzas, Konstantinos and
AU - Vlad, Delia
AU - Barmperis, Dimitrios
AU - Phychari, Stavroula
AU - Riga,
AU - Maria
AU - Apostolou, Thomas
AU - Stefanadis, Christodoulos
JO - Catheterization and Cardiovascular Interventions (Formerly Catheterization and Cardiovascular Diagnosis)
PY - 2015
VL - 86
TODO - 2
SP - 237-246
PB - Wiley
SN - 1522-1946, 1522-726X
TODO - 10.1002/ccd.25855
TODO - optical coherence tomography; stent edge dissection; clinical outcome;
acute coronary syndrome
TODO - AimsThe purpose of the present study was to assess the incidence,
predictors and long term prognosis of stent edge dissections identified
by (OCT) after the implantation of bare metal (BMS) and drug eluting
stents (DES).
Methods and ResultsWe studied 74 patients who underwent percutaneous
coronary intervention (PCI) because of an acute coronary syndrome. Edge
dissections were found in 29 of 74 patients (39.1%). Independent
predictors of edge dissections were: the presence of ST-elevation
myocardial infarction (STEMI) (P=0.005, odds ratio 11.78; 95% Cl
2.06-67.10), the small reference lumen diameter (P=0.009, odds ratio
0.11; 95% Cl 0.02-0.58) and the short stents implanted (P=0.013, odds
ratio 0.83; 95% Cl 0.72-0.96). During a follow-up period of 25.69.4
months 11 patients presented with at least one major adverse cardiac
event. Event free survival was significantly decreased in patients with
edge dissection with a flap thickness >0.31 mm compared to patients with
thinner flap or without any dissection (P<0.001).
ConclusionsOCT frequently detects edge dissections, usually related to
STEMI presentation and to PCI technique. Deep vessel wall injury at
stent edges with a dissection flap thickness more than 0.31mm carries an
adverse clinical impact on long-term clinical outcome. (c) 2015 Wiley
Periodicals, Inc.
ER -