Author + information
- Shigeo Saito,
- Akiko Maehara,
- Tadayuki Yakushiji,
- Nobuaki Kobayashi,
- Tomotaka Dohi,
- Gary Mintz and
- Masahiko Ochiai
Morphological changes after chronic total occlusions (CTO) are treated with drug–eluting stents (DES) have not been assessed in detail.
We analyzed serial (baseline and follow–up at 9±2 month) intravascular ultrasound (IVUS) studies after DES implantation into 40 CTOs (19 RCA, 10 LAD, and 11 LCX).
Overall, 33 CTOs were treated by the antegrade and 7 by the retrograde approach. Minimum lumen area (MLA) did not decrease during follow–up at which time 80% of MLA was located at minimum stent area site and the rest at the maximum neointimal hyperplasia (NIH) site. The distal reference, but not the proximal reference lumen area increased significantly at follow–up. Late acquired stent malapposition (LASM) was seen in 17 pts (42.5%, 13 body, 4 distal stent edge); the maximum malapposition area measured 3.7±3.1mm2. LASM was observed in 50% (10) of pts with increase of lumen at distal reference and 35% (7) of pts without increased distal references (p=0.34). There were 4 stent fractures that developed during follow–up and 2 tissue protrusion that were visible at baseline and follow–up. In 8 CTOs (20%), a part of stent was implanted into a subintimal space; in these 8 pts, maximum %NIH was less and MLA greater in the subintimal segment than in the true lumen segment although the incidence of LASM was similar.
Despite high incidence of LASM at follow–up after CTO treatment, it was not related to stenting into the subintimal space or distal vessel enlargement.
Poster Sessions, Expo North
Saturday, March 09, 2013, 3:45 p.m.–4:30 p.m.
Session Title: Chronic Total Occlusions
Abstract Category: 38. TCT@ACC–i2: Intravascular Imaging and Physiology
Presentation Number: 2103–240
- 2013 American College of Cardiology Foundation