Author + information
- Masaru Ishida1,
- Gary Mintz2,
- Mitsuaki Matsumura2,
- Dong Yin3,
- Allen Jeremias4,
- Ziad Ali5,
- Jane Cao4,
- Jeronimo Rodriguez4,
- Fernando Sosa6,
- Jeffrey W. Moses5,
- Elizabeth Haag7,
- Richard Shlofmitz4 and
- Akiko Maehara2
- 1CRF, New York, New York, United States
- 2Cardiovascular Research Foundation, New York, New York, United States
- 3Fuwai Hospital, Beijing, Beijing, China
- 4St. Francis Hospital, Roslyn, New York, United States
- 5NewYork-Presbyterian Hospital/Columbia University Medical Center, New York, New York, United States
- 6Abbott Vascular, New York, New York, United States
- 7St Francis Hospital, Roslyn, New York, United States
The prevalence and contributing factors to the development of intra-procedural thrombus (IPT) as detected by optical coherence tomography (OCT) are unknown.
IPT and underlying plaque morphology were evaluated by OCT in 187 stable pts with chronic clopidogrel usage who underwent elective coronary stenting (R-ZES or CoCr-EES). Large lipidic plaque as evaluated by pre- and/or post-stent OCT and was defined as an angle >90°. IPT was defined as a new intraluminal thrombus (>200μm in diameter) in the post-stent OCT image (Figure). P2Y12 reaction units (PRU) were measured at the time of admission.
Mean age was 69±11 yrs. Although IPT was detected only in 2 pts (1.1%) by angiography, OCT detected IPT (median thrombus length: 0.96mm) in 12 pts (6.4%). There was no difference in medications (including DAPT usage) or PRU values, but pts with IPT were younger and had longer lesions and a higher prevalence of a large amount of OCT-detected lipidic plaque (Table).
|With intra-procedural thrombus (n=12)||Without intra-procedural thrombus (n=175)||Univariate logistic model|
|Age (yrs)||64 (58, 68)||71 (63, 78)||0.61 (0.38-0.99)||<0.05|
|Oral anticoagulants||0%||5%||Not applicable||Not applicable|
|P2Y12 reaction units (PRU)||222 (116, 274)||210 (145, 275)||1.00 (0.99-1.01)||0.71|
|Lesion length (mm)||29.4 (19.9, 39.7)||23.0 (17.4, 31.7)||1.04 (1.00-1.07)||<0.05|
|Lipidic plaque behind stent >90°||75%||10%||27.9 (6.9-113.0)||<0.001|
In stable pts undergoing stent implantation, the prevalence of IPT as detected by OCT is low (6.4%) and is associated with underlying lesion morphology (length and lipid), not with PRU or DAPT.
IMAGING: Imaging: Intravascular