Key result
Stent segments with angulation >29 degrees had a higher prevalence of in-stent neoatherosclerosis compared to those with angulation ≤29 degrees (18.4% vs. 9.9%, P=0.032).
Why the study?
Does stent curvature and bifurcation influence the localization of in-stent neoatherosclerosis after sirolimus-eluting stent implantation?
Cohort (n=331)
Does stent curvature and bifurcation influence the localization of in-stent neoatherosclerosis after sirolimus-eluting stent implantation?
Absolute Event Rate: 18.4% vs 9.9%
p-value: p=0.032
May prompt targeted OCT surveillance near curvatures; hypothesis-generating for stent design trials.
Background: In-stent neoatherosclerosis (ISNA) is a final common pathway of late-stent failure. However, distribution of ISNA has been little reported. This study was to evaluate the localization of ISNA in relation to curvatures and bifurcations after stent implantation using optical coherence tomography (OCT). Methods: We retrospectively selected patients who underwent OCT examination 12 months after stent (sirolimus-eluting stents, SES) implantation. A stent curvature was defined if the angulation of the stent segment was >29. Distribution of ISNA in relation to stent curvature and bifurcation was evaluated. Results: Totally, 331 patients were enrolled. The mean follow-up time was 15 months. Forty-one (12.3%) patients were found with ISNA. OCT results showed that stents with ISNA had thicker neointima (mean neointima thickness: 0.16 vs. 0.08 mm, P<0.001) compared to patients without ISNA. Segments with angulation >29 had a higher prevalence of ISNA compared with to angulation 29 [18 (18.4%) vs. 23 (9.9%), P=0.032]. ISNA was more frequently located at the "inner curvature" than the "outer curvature" (77.8% vs. 22.2%, P=0.018). If ISNA occurred in a branch, it was more often on the opposite side of the branch compared with the same side of the branch [21 (77.8%) vs. 6 (22.2%), P=0.004].
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Zou et al. (2016) conducted a cohort in Post-stent implantation (n=331). Stent curvature (angulation >29 degrees) vs. Stent angulation ≤29 degrees was evaluated on Prevalence of in-stent neoatherosclerosis (ISNA) (p=0.032). Stent segments with angulation >29 degrees had a higher prevalence of in-stent neoatherosclerosis compared to those with angulation ≤29 degrees (18.4% vs. 9.9%, P=0.032).
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