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Characteristics of abnormal post-stent optical coherence tomography findings in hemodialysis patients

Yutaka Matsuhiro1, Yasuharu Matsunaga-Lee1, Daisuke Nakamura1

  • 1Division of Cardiology, Osaka Rosai Hospital, Osaka, Japan.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|March 28, 2019
PubMed

Insights

Patients on hemodialysis (HD) undergoing percutaneous coronary intervention (PCI) show worse outcomes. Optical coherence tomography (OCT) revealed higher rates of dissections, under-expansion, and eccentricity in HD patients post-PCI.

Area of Science:

  • Cardiovascular Imaging
  • Interventional Cardiology
  • Nephrology

Background:

  • Clinical outcomes after percutaneous coronary intervention (PCI) are poorer in hemodialysis (HD) patients.
  • Optical coherence tomography (OCT) offers detailed insights into post-PCI findings influencing outcomes.
  • Abnormal OCT findings in HD patients remain under-investigated.

Purpose of the Study:

  • To compare abnormal post-stent OCT findings between HD and non-HD patients.
  • To identify OCT-derived predictors of adverse outcomes in HD patients undergoing PCI.

Main Methods:

  • 139 PCI lesions (21 in HD, 118 in non-HD) assessed with OCT.
  • Comparison of post-stent OCT findings: edge dissections, under-expansion index, and stent eccentricity index.
  • Evaluation of device-oriented clinical events (DoCEs) at 8-month follow-up.

Main Results:

  • HD patients exhibited a higher prevalence of distal edge dissections (16.7% vs. 2.8%).
  • Significantly lower under-expansion (0.76 vs. 0.85) and stent eccentricity (0.82 vs. 0.88) indices were observed in HD patients.
  • HD patients had a higher cumulative rate of DoCEs (23.8% vs. 5.2%).

Conclusions:

  • Detailed OCT analysis revealed a higher incidence of distal edge dissections, under-expansion, and stent eccentricity in HD patients.
  • These OCT findings may contribute to the worse clinical outcomes observed in HD patients post-PCI.
Abstract

Keywords:
chronic renal diseasecoronary artery diseaseoptical coherence tomographystents

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