Neointimal Coverage After Drug-Eluting Stent Implantation: Insights from Optical Coherence Tomography

Optical coherence tomography (OCT), which provides high-resolution imaging of the coronary vasculature, has provided novel insights into the pathophysiology of neointimal growth after drug-eluting stent (DES) implantation. The natural history, time course, and characteristics of strut coverage with neointima have been well defined by OCT. Pathology studies have identified strut coverage as a risk factor for stent thrombosis, and OCT studies have shown that next-generation DES have better strut coverage than first-generation DES. By reducing the incidence of stent thrombosis, improved strut coverage should lead to favorable clinical safety and the feasibility of shorter-duration dual antiplatelet therapy after DES implantation.