Key result
Peri-stent contrast staining (PSS) sites had significantly higher rates of thrombus compared to non-PSS sites (64% vs. 9%, P=0.012), suggesting high thrombogenicity at these locations.
Why the study?
Does the presence of peri-stent contrast staining (PSS) correlate with delayed neointimal coverage and increased thrombogenicity compared to non-PSS sites in patients with drug-eluting stents?
Observational (n=10)
Does the presence of peri-stent contrast staining (PSS) correlate with delayed neointimal coverage and increased thrombogenicity compared to non-PSS sites in patients with drug-eluting stents?
Answers are grounded in this paper and cite their sources.
Peri-stent contrast staining after drug-eluting stent implantation is associated with poor neointimal coverage and increased local thrombogenicity, suggesting it is a high-risk marker for late stent thrombosis.
BACKGROUND: Peri-stent contrast staining (PSS) has been recognized as a predictor of late stent thrombosis following drug-eluting stent (DES) implantation. However, the intravascular conditions at PSS sites remain unclear. METHODS AND RESULTS: We evaluated 10 patients (median age 72 years, 80% male) with stable angina pectoris by coronary angioscopy. The patients had a total of 11 DES implantations (5 sirolimus-eluting stents; 4 paclitaxel-eluting stents; 2 everolimus-eluting stents) that showed PSS. Neointimal coverage (NIC), presence of thrombus, and yellow plaques underneath the stent were compared between PSS and non-PSS sites for each stent. NIC was graded as: grade 0, struts exposed; grade 1, struts bulging into the lumen, although covered; grade 2, struts embedded by neointima, but translucent; grade 3, struts fully embedded and invisible. Mean follow-up was 394±206 days (median: 289). NIC grade was lower at PSS sites (P=0.021) with 8 out of 11 stents (73%) having grade 0. Angioscopy detected a thrombus more frequently at PSS sites than at non-PSS sites (64% vs. 9%, P=0.012). Yellow plaques tended to be more significant at PSS sites than at non-PSS sites (82% vs. 45%, P=0.091). CONCLUSIONS: The angioscopic findings suggest high thrombogenicity at PSS sites.
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Ishihara et al. (2013) conducted an observational in Stable angina pectoris with peri-stent contrast staining (n=10). Peri-stent contrast staining (PSS) sites vs. Non-PSS sites was evaluated on Presence of thrombus (p=0.012). Peri-stent contrast staining (PSS) sites had significantly higher rates of thrombus compared to non-PSS sites (64% vs. 9%, P=0.012), suggesting high thrombogenicity at these locations.
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