Study on the potential clinical significance of subclinical stent edge effects after drug-eluting stent implantation

Figures

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  Fig. 1. Study flow chart and study design. ACS, acute coronary syndrome; DES, drug eluting stent; EE, edge effect; ΔMLA%, the percent changes of minimal luminal area; OCT, optical coherence tomography; PCI, percutaneous coronary intervention; ROC, receiver-operating characteristic; TLF, target lesion failure.

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  Fig. 2. Receiver-operating characteristic (ROC) analysis for ΔMLA% predicting EE-TLF within 5 years. AUC, area under the curve; ΔMLA%, the percent changes of minimal lumen area; NPV, negative predictive value; PPV, positive predictive value; ROC, receiver-operating characteristic; TLF, target lesion failure.

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  Fig. 3. Kaplan Meier and Landmark analysis of sDES-EE versus non-sDES-EE at 1 year for EE-TLF at 5 years. a Kaplan Meier analysis. b Landmark analysis.

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  Fig. 4. sDES-EE associated with total EE-TLF and each component of EE-TLF within 5 years. DES, drug eluting stent; EE, edge effect; sDES-EE, subclinical DES-EE; TLF, target lesion failure; TLR, target lesion revascularization; TVMI, target vessel myocardial infarction.

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  Fig. 5. Representative case with 1-year sDES-EE and EE-TLF between 1 ∼ 5 years. The figure in the upper row shows the angiography results of the right anterior oblique foot position, and the white solid arrow points to the proximal part of DES in the anterior descending branch; (A) indicates immediately result after the implantation of DES; (B) indicates the angiographic sDES-EE results at 1-year follow-up after PCI; (C) indicates that EE-TLF occurred between 1 year and 5 years after PCI. The figure in the middle row shows the Simulated diagram. (A’), (B’) and (C’) simulates the result of (A), (B) and (C) separately. The figure in the lower row shows the cross-sectional OCT image of the white solid arrow points in the upper figure. (A”) corresponds to (A), showing that the plaque area was 3.85 mm2 and plaque burden was 30.8% at the proximal DES edge immediately after PCI, of which fibrous components accounted for 85.4% and lipid components accounted for 0.0%. (B”) corresponds to (B), showing that the plaque area increased to 7.22 mm2 and plaque burden increased to 62.7% at the same site 1 year after PCI, of which fibrous components accounted for 55.0% and lipid components increased to…