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Stent expansion evaluated by optical coherence tomography and subsequent outcomes
Bom Lee1, Teklay Gebrehaweria Baraki1, Byung Gyu Kim2
1Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 03722 Yonsei-ro 50-1, Seodaemun-gu, Seoul, South Korea.
Scientific Reports
|March 7, 2023
Summary
Achieving adequate minimal stent area (MSA) is crucial for better outcomes after stenting. However, excessive stent expansion may increase the risk of adverse events, indicating a need for optimal implantation criteria.
Area of Science:
- Cardiovascular Interventions
- Medical Imaging
- Interventional Cardiology
Background:
- Optical coherence tomography (OCT) is vital for assessing stent implantation.
- Minimal stent area (MSA) has been linked to adverse events post-stenting.
Purpose of the Study:
- To evaluate the impact of various stent expansion and apposition indices on clinical outcomes.
- To identify optimal stent implantation criteria using post-stent OCT.
Main Methods:
- 1071 patients with 1123 native coronary artery lesions treated with new-generation drug-eluting stents.
- Post-stent OCT analysis to assess stent expansion and apposition indices.
- Evaluation of associations between indices and device-oriented clinical endpoints (DoCE).
Main Results:
- MSA was negatively correlated with DoCE risk (HR 0.80).
- Excessive volumetric stent expansion (stent expansion by linear model) was associated with increased DoCE risk (HR 1.02).
- Specific categorical criteria (MSA < 5.0 mm², MSA/distal reference lumen area < 90%, stent expansion by linear model ≥ 65.0%) were independently associated with DoCE.
Conclusions:
- Sufficient stent expansion, meeting absolute and relative MSA criteria, is essential for improving clinical outcomes.
- Excessive volumetric stent expansion may have detrimental effects, underscoring the need for precise implantation.
- OCT guidance is crucial for optimizing stent deployment and patient outcomes.
