Effects of TCFA on stent neointimal coverage at 9 months after EXCEL drug-eluting stent implantation assessed by OCT.

Abstract

BACKGROUND:

The aim of this study was to investigate the effects of thin-cap fibroatheromas (TCFAs) on stent neointimal coverage at the 9‑month follow-up after EXCEL stent implantation assessed by optical coherence tomography (OCT).

METHODS:

A total of 93 patients with non-ST elevation acute coronary syndrome (NSTEACS) who underwent EXCEL stent implantation were prospectively enrolled in the study and divided into a TCFA group (n = 47) and a non-TCFA group (n = 46) according to whether EXCEL stents covered the TCFAs. A TCFA was defined as a plaque with lipid content in more than one quadrant and fibrous cap thickness measuring less than 65 μm. The effect of TCFAs on stent neointimal coverage at the 9‑month follow-up after stent implantation was evaluated by OCT. The primary study endpoints were the incidence of neointimal uncoverage and stent malapposition.

RESULTS:

At the 9‑month follow-up, the minimal lumen diameter of the TCFA group tended to be smaller (2.8 ± 0.8 vs. 2.1 ± 0.8, p = 0.08) and the diameter of stenosis in the TCFA group tended to be larger (15.1 ± 10.3% vs. 26.3 ± 15.1%, p = 0.08) than those in the non-TCFA group. The mean intimal thickness of the TCFA group was significantly lower than that of the non-TCFA group (67.2 ± 35.5 vs. 145.1 ± 48.7, p < 0.001). The uncovered struts (10.1 ± 9.7 vs. 4.8 ± 4.3, p = 0.05) and malapposed struts (2.1 ± 4.7 vs. 0.3 ± 0.5, p = 0.003) in the TCFA group were more significant than those in the non-TCFA group. Multivariate analysis showed that TCFAs and lesion types were independent predictors of incomplete neointimal coverage (p < 0.05), and lesion types were independent predictors of stent malapposition (p < 0.05).

CONCLUSION:

In patients with NSTEACS, TCFAs delayed endothelium coverage at 9 months after stent implantation, and TCFAs were independent predictors of incomplete neointimal coverage of the stent.

• Authors: Jiao Zhang, Yuanyuan Duan, Hong Yu, Limin Jing, Yi Li, Xiaowei Jia, Dekui Jin, Huiliang Liu
• Journal: Herz (Herz) Vol. 48 Issue 1 Pg. 64-71 (Feb 2023) ISSN: 1615-6692 [Electronic] Germany
• Vernacular Title: Auswirkungen von TCFA auf die neointimale Abdeckung des Stents 9 Monate nach Implantation eines medikamentenfreisetzenden EXCEL-Stents, bewertet durch OCT.
• PMID: 34981128 (Publication Type: Journal Article)
• Copyright: © 2022. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.

Topics

• Humans
• Drug-Eluting Stents
• Coronary Artery Disease (diagnostic imaging, surgery)
• Tomography, Optical Coherence (methods)
• Treatment Outcome
• Stents
• Atherosclerosis
• Neointima (diagnostic imaging, pathology)
• Percutaneous Coronary Intervention
• Acute Coronary Syndrome (diagnostic imaging, surgery)
• Coronary Vessels (diagnostic imaging, surgery)