Unit:
Τομέας ΠαθολογίαςLibrary of the School of Health Sciences
Dissertation committee:
Ηλιόπουλος Δημήτριος, Επίκουρος Καθηγητής, Ιατρική, ΕΚΠΑ
Τούτουζας Κωνσταντίνος, Καθηγητής, Ιατρική, ΕΚΠΑ
Στεφανάδης Χριστόδουλος, Ομότιμος Καθηγητής, Ιατρική, ΕΚΠΑ
Τσιάμης Ελευθεριος, Αναπληρωτής Καθηγητης, Ιατρική, ΕΚΠΑ
Αγγέλη Κωνσταντίνα, Αναπληρώτρια Καθηγήτρια, Ιατρική, ΕΚΠΑ
Αλεξόπουλος Δημήτριος, , Αναπληρωτής Καθηγητης, Ιατρική, ΕΚΠΑ
Τούσουλης Δημήτριος, Καθηγητής, Ιατρική, ΕΚΠΑ
Original Title:
Εκτίμηση του αγγειακού τραύματος αμέσως μετά την εμφύτευση ενδοστεφανιαίων προθέσεων με τη χρήση της οπτικής συνεκτικής τομογραφίας. Προγνωστική σημασία του φαινομένου
Translated title:
Impact of coronary artery stent edge dissections on long-term clinical outcome in patients with acute coronary syndrome: an optical coherence tomography study
Summary:
Aims
The 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 Results
We studied 152 patients who underwent percutaneous coronary intervention (PCI) because of an acute coronary syndrome. Edge dissections were found in 61 patients (40.1%). Independent predictors of edge dissections were: the presence of ST‐elevation myocardial infarction (STEMI) (p<0.01, oddsratio 4.76, 95%CI 2,19-10,33), the small reference lumen diameter (ρ=0,001, oddsratio 0,26, 95% Cl 0,12-0,59) and the short stents implanted (ρ = 0,004, oddsratio 0,90, 95% Cl 0,85-0,96). During a follow‐up period of 45 months 25 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 >350μm compared to patients with thinner flap or without any dissection ((p <0,001)).
Conclusions
OCT 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 350μm carries an adverse clinical impact on long‐term clinical outcome.
Main subject category:
Health Sciences
Keywords:
optical coherence tomography, Stent edge dissection
Number of references:
390
